BiPAP无创通气治疗AECOPD合并Ⅱ型呼吸衰竭的临床研究

Clinical study of non-invasive bi-level positive pressure ventilation for acute exacerbation of chronic obstructive pulmonary disease patients with Type Ⅱ respiratory failure

目的研究在慢性阻塞性肺疾病急性加重期(AECOPD)合并Ⅱ型呼吸衰竭患者中使用BiPAP无创通气的疗效。方法 46例AECOPD合并Ⅱ型呼吸衰竭患者分为治疗组23例(常规治疗联合BiPAP无创通气)和对照组23例(常规治疗)。观察治疗前和治疗后1 h、4 h、24 h、48 h动脉血气分析与有创通气率、病死率及住院日。结果治疗组相比对照组PaO2上升和PaCO2下降更明显,且治疗组在有创通气率、病死率及住院日等方面均低于对照组。结论BiPAP无创通气治疗AECOPD合并Ⅱ型呼吸衰竭较常规治疗方法能更快、更好地改善患者病情,且可以减少有创通气率、病死率和住院日。

Objective To study the effect of non-invasive bi-level positive pressure ventilation for acute exacerbation of chronic obstructive pulmonary disease patients with type II respiratory failure. Methods A total of 46 AECOPD patients with type II respiratory failure were divided into two groups. Treatment group included 23 patients were given routine therapy and non-invasive hi-level positive pressure ventilation; Control group included 23 patients were only given routine therapy. Observations of the clinical indicators of the arterial blood gas analysis, invasive ventilation rate, mortality and hospitalization days were made before and after the treatment at 1 h, 4 h, 24 h, 48 h. Results PaO2 increased and PaCO2 decreased more significantly in treatment group comparing to the control group, and invasive ventilation, the rate of mortality and hospitalization were all lower in the treatment group than in the control group. Conclusion Non-invasive bi-level positive pressure ventilation in the treatment of AECOPD patients with type II respiratory failure is better than that of the conventional treatment method, and can be faster, better for improving the patient＇s condition, and can reduce invasive ventilation rate, mortality rate and hospital stay.