经面罩无创双水平正压通气在老年重症慢性阻塞性肺病急性加重期合并Ⅱ型呼吸衰竭治疗中的应用

Applicion of BiPAP in elderly patients with severe COPD during acute exacerbation period com-plicated with type H respiratory failure

目的探讨经面罩无创双水平正压通气（BiPAP）治疗老年重症慢性阻塞性肺疾病急性加重期（AE-COPD）合并Ⅱ型呼吸衰竭的疗效。方法选择老年重症AECOPD合并Ⅱ型呼吸衰竭患者50例，比较治疗前后的动脉血气[动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaC02）、pH值、动脉血氧饱和度（SaO2）]和生命体征[呼吸（RR）、心率（HR）]的变化。结果治疗后Pa02、SaO2、pH值较治疗前明显升高，RR、HR、PaCO2较治疗前明显下降，治疗前后比较差异有统计学意义（P〈0．01）。结论对老年重症AECOPD合并Ⅱ型呼吸衰竭患者早期应用BiPAP无创通气治疗疗效满意，无明显并发症，可作为一线治疗手段推广应用。

Objective To investigate the clinical effect of Bi-level positive airway pressure venti- lation （BiPAP） on respiratory failure resulted from acute exacerbation period of chronic obstructive pul- monary disease （AECOPD）. Methods Fifty elderly patients with acute respiratory failure resulted from AECOPD were choosed in the study. The changes in the artery blood gas（PaO2 ,SaO2 ,pH,SaO2 ） and vital signs （ RR, HR） were compared before and after the treatment. Results After treatment, the PaO2, SaO2 ,pH values were higher,and the RR, HR and PaCO2 were lower, there were significant differences （P 〈 0. 01 ）. Conclusions BiPAP assisted ventilation is certainly effective in the treatment of COPD combined with typeⅡ respiratory failure, and has no obvious complications, is worth to be oooularized.