无创双水平气道正压通气治疗慢性阻塞性肺疾病呼吸衰竭的临床研究

Clinical Research of Noninvasive Bi-level Positive Airway Pressure Ventilation Therapy for Respiratory Failure Resulted from Chronic Obstructive Pulmonary Disease

目的分析研究无创双水平气道正压通气(BiPAP)治疗慢性阻塞性肺疾病(COPD)呼吸衰竭的作用。方法将84例符合入选标准的COPD合并Ⅱ型呼吸衰竭的患者随机分为对照组(42例)和观察组(42例)。对照组采用常规的治疗方法(药物治疗+吸氧);观察组采用常规的治疗方法加Bi-PAP呼吸机经面罩气道正压通气。观察两组患者治疗前、后的临床指标和动脉血气。结果治疗后两组患者的呼吸频率(RR)、心室率(HR)、动脉血pH、PaO2、PaCO2和SaO2均较治疗前明显改善(P<0.05)。观察组治疗4、24 h后的pH、PaO2和SaO2较对照组上升更明显,PaCO2下降更明显(P<0.05)。观察组和对照组的治疗成功率分别为92.86%和76.19%,两组比较差异有统计学意义(P<0.05),观察组无明显不良反应发生。结论无创双水平气道正压通气对COPD呼吸衰竭患者的疗效肯定,是一种有效、简便、无创而实用的治疗方法。

Objective To study the effects of noninvasive bi-level positive airway pressure（BiPAP）ventilation on respiratory failure resulted from chronic obstructive pulmonary disease（COPD）.Methods 84 patients accorded with the inclusion criteria of COPD complicated with respiratory failure typeⅡwere randomly divided into the control group（42 cases）and the observation group（42 cases）.Patients in control group received conventional therapy（drug treatment ＋ oxygen inhalation）,patients in observation group received BiPAP ventilation through mask on the basis of conventional therapy.The clinical indexes and arterial blood gas of both groups before and after treatment were observed.Results The respiratory rate,heart rate,arterial pH,PaO2,PaCO2,and SaO2 after treatment were significantly improved comparing with before treatment in both group（P0.05）.At 4,24 h after treatment,arterial pH,PaO2,and SaO2 of observation group were significantly higher than control group,PaCO2 were significantly lower than control group（P0.05）.The achievement ratio of observation group and control group were respectively 92.86%and 76.19%,there was significant difference between two groups（P0.05）.No obvious adverse reaction occurred in observation group.Conclusion Noninvasive BiPAP ventilation has definite effect on respiratory failure resulted from chronic obstructive pulmonary disease;it was an effective,simple,noninvasive and practical treatment method.