双水平无创正压通气治疗老年慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭疗效观察

Effects of noninvasive bilevel positive airway pressure ventilation on senile patients with chronic obstructive pulmonary disease complicated by typeⅡ respiratory failure

目的观察双水平无创正压通气(BiPAP)对老年慢性阻塞性肺疾病(COPD)并发Ⅱ型呼吸衰竭患者的治疗效果。方法 32例老年COPD伴Ⅱ型呼吸衰竭的患者除常规综合治疗外,选用BiPAP无创呼吸机进行治疗,在应用无创呼吸机前、应用无创呼吸机4 h、24 h后及无创呼吸机治疗结束后行血气分析检查,同时观察临床症状。结果与治疗前相比,机械通气4 h后PaO2上升、PaCO2下降,但差异无统计学意义,治疗24 h后pH、PaO2、PaCO2变化有统计学差异。结论 BiPAP无创正压通气治疗COPD伴Ⅱ型呼吸衰竭有较好的临床疗效,尤其对于老年患者,使用方便,减少了气管插管的发生,值得临床推广。

Objective To explore the clinical effect of noninvasive bilevel positive airway pressure（BiPAP）ventilation in senile COPD patients with type Ⅱ respiratory failure.Methods Based on the routine therapy,32 senile COPD patients with type Ⅱ respratory failure were additionally given noninvasive bilevel positive airway pressure ventilation.Arterial blood gas analysis was measured,and changes of clinical symptoms were recorded before and after treatment for 4 h and 24 h.Results After mechanical ventilation treatment for 4 h,PaO2 increased and PaCO2 decreased,but there was no statistically significant difference.The pH,PaO2,PaCO2 in patients were improved significantly after 24 h treatment.Conclusion BiPAP is an effective therapy for type Ⅱ respiratory failure due to COPD in older patients.