无创正压通气治疗AECOPD合并Ⅱ型呼吸衰竭的临床疗效观察

The observation on curative effect of non-invasive positive airway pressure ventilation in treatment to AECOPD patients with typeⅡrespiratory failure

目的观察双水平无创正压通气治疗慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmo-nary disease,AECOPD)合并Ⅱ型呼吸衰竭患者的疗效。方法 79例AECOPD合并Ⅱ型呼吸衰竭的患者,随机分为使用Bi-PAP无创呼吸机行双水平正压辅助通气治疗组(治疗组,39例)和常规治疗组(对照组,40例),观察和比较两组患者治疗前后临床症状及动脉血气的变化情况。结果治疗组患者在治疗7天后pH、PO2、PCO2结果均较治疗前明显改善(P<0.01),心率及呼吸频率也明显改善(P<0.05),且治疗组与对照组比较各项指标改善更明显(P<0.05)。结论 Bi-PAP无创呼吸机双水平正压辅助通气治疗AECOPD合并Ⅱ型呼吸衰竭患者有显著的疗效,值得临床推广及应用。

Objective To observe the curative effect of Bi-level Positive Airway Pressure Non-invasive mechanical treatment to AECOPD patients with typeⅡrespiratory failure.Methods A total of 79 patients who suffered from AECOPD with typeⅡrespiratory failure were divided into two groups.The therapy group included 39 patients who were given routine treatment（meditations and oxygen） and Bi-PAP non-invasive ventilation;the contrast group included 40 patients who were only given routine treatment.Arterial blood gases before and after treatment,the clinical symptom were observed and compared.Results After 7 days treatment,the arterial pH and PaO2 increased significantly in the therapy group（P0.01）,and PaCO2 decreased significantly（P0.01）.The heart rate and the respiratory rate were also improved significantly（P0.05）.The arterial blood gases and the clinical symptom of the therapy group were improved more significantly than the contrast group（P0.05）.Conclusion The use of Bi-PAP non-invasive ventilation in AECOPD patients with type Ⅱrespiratory failure is effective in improving arterial blood gases and the clinical symptom.