无创正压通气治疗慢性阻塞性肺疾病合并呼吸衰竭的临床疗效观察

The clinical curative effect observation on non-invasive positive pressure ventilation to chronic obstructive pulmonary diseases and respiratory failure

目的:对无创正压通气(NIPPV)治疗慢性阻塞性肺疾病合并呼吸衰竭的临床疗效进行观察和研究。方法:选择2008年4月—2011年4月治疗的60例慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者作为试验组,进行NIPPV治疗。选择60例对照组患者进行常规治疗。结果:两组患者的氧分压(PaO2),二氧化碳分压(PaCO2),血氧饱和度(SpO2),心率(HR)、呼吸(RR)差异均有统计学意义(P<0.01),试验组患者的血气分析结果显著好于对照组。试验组有2例中转有创通气治疗,气管插管率为3.3%;有1例出现气促症状,2例出现咽喉干燥症状,1例出现腹胀。1例死于多器官功能衰竭。对照组有3例出现气促症状,3例死于多器官功能衰竭,8例行气管插管,插管率为13.3%。试验组患者的气管插管率显著低于对照组。两组患者的病死率差异无统计学意义(P>0.05)。结论:无创正压通气治疗慢性阻塞性肺疾病合并呼吸衰竭,可改善患者预后,降低气管插管率,减少并发症的发生,安全性较好。

Objective - To observe and study the clinical efficacy of noninvasive positive pressure ventilation （NIP- PV） in the treatment of chronic obstructive pulmonary disease with respiratory failure. Methods：Select the 60 pa- tients in department from April 2008 to April 2011 with chronic obstructive pulmonary disease combined with type respiratory failure as experimental group to get the treatment of NIPPV. Also select 60 cases as the control group treated with conventional treatment. Results ..The patients of two groups were significantly different in partial pres- sure of oxygen （PaOz） ,partial pressure of carbon dioxide （PaCO2） ,oxygen saturation of blood （SpO2） ,cardiac rate （HR） ,breathing rate （RR）（P^O. 01）. The blood gas analysis results of experimental group patients were significant- ly better than those of the control group. 2 patients in experimental group had transit-invasive ventilation therapy ,and the rate of endotracheal intubation was 3.3 %. One patient developed shortness of breath symptoms, 2 cases had dry throat symptoms, and one cases had abdominal distension. One patient died of multiple organ failure. The control group had three cases with shortness of breath symptoms,three patients died of multiple organ failure,8 patients un- derwent endotracheal intubation,and the intubation rate was 13.3%. The rate of endotracheal intubation of the exper- imental group were significantly lower than that of the control group. The mortality rate of two groups patients had no significant difference （P〉0. 05）. Conclusion：The treatment of noninvasive positive pressure ventilation in the treatment of chronic obstructive pulmonary disease complicated by respiratory failure could improved patient out- comes ,reduce the rate of endotraeheal intubation and reduce the incidence of complications. It had Rood security.