纤支镜联合无创通气在COPD呼衰中的应用

The application of combination fibrobronchoscopy with noninvasive positive pressure ventilation in patients with respiratory failure due to chronic obstructive pulmonary disease

目的探讨纤支镜联合无创通气在COPD合并呼衰中的应用价值。方法 92例COPD合并呼衰患者常规治疗基础上行纤支镜灌洗,38例患者灌洗后予无创通气治疗,记录治疗前、后动脉血气、血常规、胸片等指标。结果 54例患者灌洗后呼衰缓解,38例呼衰改善不明显者予无创通气治疗,与治疗前比较,动脉血气指标明显改善(P<0.01)。结论对于分泌物较多的COPD呼衰患者,纤支镜灌洗有利于解除气道阻塞,改善血气交换。

Objective To investigate the application value of combination fibrobronchoscopy with noninvasive positive pressure ventilation in patients with respiratory failure due to chronic obstructive pulmonary disease（COPD）.Methods 92 patients with respiratory failure due to COPD were performed with fibrobronchoscopy to assimilated secretion on the ground of routine treatment.38 cases were ventilated with noninvasive positive pressure ventilation.The data were recorded on the measures of the blood gas index,amount of leucocyte and chest X-ray scan before and after treatment.Results 54 patients＇ symptoms of respiratory failure relieved,and their blood gas index improved obviously.38 patients with less improvement on their symptoms had better on the measures of their blood gas index after using noninvasive positive pressure ventilation.Conclusions Bronchoalveolar lavage can remove bronchus obstruction quickly and correct symptoms for those patients with much secretion in respiratory failure due to COPD.It will be better to use noninvasive positive pressure ventilation for those who had less improved symptoms before.