喉罩气道导管在慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者无创通气中的应用研究

Study of non-invasive laryngeal mask airway tube in chronic obstructive pulmonary disease patients with Ⅱ type respiratory failure

目的无创通气是慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)合并Ⅱ型呼吸衰竭患者救治的有效手段。既往多采用口鼻面罩通气,常因耐受性差而影响预后。文中旨在探讨喉罩气道导管在COPD合并Ⅱ型呼吸衰竭中的疗效。方法 68例COPD合并Ⅱ型呼吸衰竭患者随机分成2组(各34例),常规组采用普通鼻面罩,改良组采用改良型喉罩气道导管。分别观察2组动脉血气、BODE指数、无创通气时间等指标。结果与常规组相比,改良组PaCO2、PaO2均有显著改善,差异有统计学意义(P<0.05、P<0.01);常规组通气治疗操作过程所需花费时间显著短于改良组(P<0.001);改良组无创时间明显缩短,与常规组相比,差异有统计学意义(P<0.001)。结论改良型喉罩气道可能比普通鼻面罩更适合COPD合并Ⅱ型呼吸衰竭患者的通气治疗。

Objective Noninvasive ventilation is an effective method in the COPD patients with Ⅱtype respiratory failure. The poor comfortable of muzzle mask always influence the outcome. The aim of this study was to determine the effect of laryngeal mask applied in the COPD patients with Ⅱ type respiratory failure. Methods 68 COPD patients with Ⅱ type respiratory failure were equally divided into two groups. The conventional group received common non-invasive nasal mask ventilation, while the experimental group was treated with laryngeal mask. The related indicators such as arterial blood gas changes, the BODE index and ventilation time were recorded and compared between the two groups. Results There was no difference in blood PH value between the two groups （P 〉 O. 05）. The PaCO2, PaO2 in the experimental group was much better than those in the conventional group respectively （P 〈O. 05,P 〈0.01 ）. The time needed for treatment was significantly shorten in the improved group （P 〈 0. 001 ）. Conclusion The laryngeal mask ventilation may be better than common nasal mask ventilation in the non-invasive treatment of COPD patients with II type respiratory failure.