无创机械通气治疗老年慢性阻塞性肺疾病合并呼吸衰竭临床分析

Clinical effect of noninvasive positive pressure ventilation on chronic obstructive pulmonary disease complicated with typeⅡrespiratory failure

目的:探讨无创正压机械通气(NIPPV)治疗慢性阻塞性肺疾病(COPD)合并呼吸衰竭的临床疗效。方法:将符合标准的COPD合并Ⅱ型呼吸衰竭患者75例,随机分为观察组40例和对照组35例。观察两组患者治疗前后临床症状、生命体征、血气分析变化。结果:治疗48h后,观察组呼吸频率及心率逐渐减慢,与治疗前及对照组比较差异显著(P<0.05);观察组PaO2、氧合指数(PaO2/FiO2)明显高于对照组(P<0.05),而PaCO2在两组间差异无统计学意义(P>0.05);观察组患者住院时间、气管插管率以及死亡率较对照组低(P<0.05)。结论:NIPPV治疗能明显改善COPD合并呼吸衰竭患者的通气功能,缩短住院时间,降低病死率。

Objective： To investigate clinical efficacy of non-invasive positive pressure ventilation（NIPPV） therapy on patients with chronic obstructive pulmonary disease（COPD） complicated with typeⅡrespiratory failure.Methods： A total of 75 patients with COPD complicated with typeⅡrespiratory failure were randomly divided into observation group（40 cases） and control group（35 cases）.Patients in control group only received the comprehensive treatment,while others received added NIPPV therapy based on conventional treatment.The curative effect was observed and compared between two groups.Results：After treatment for 48 h,respiratory rate and heart rate in observation group were significantly lower than those in the control group（P0.05）;PaO2 and PaO2/FiO2 in observation group were significantly higher than those in the control group（P0.05）;length of hospital stay,tracheal intubation rate and mortality in observation group were significantly lower than those in control group（P0.05）.Conclusion： NIPPV can obviously improve ventilation function,shorten length of stay and decrease mortality.