慢阻肺呼吸衰竭的机械通气治疗

Effect of bi-level positive airway pressure on acute respiratory failure in patients with chronic obstructive pulmonary disease

目的 :评价双水平气道正压 (BiPAP)通气对慢性阻塞性肺病 (COPD)急性加重期Ⅱ型呼衰患者的疗效。方法 :在相同的常规治疗下 ,BiPAP治疗组 2 5例应用Bi PAP通气经鼻 (面 )罩给氧 ,对照组 2 1例经鼻导管给氧 ,用血气分析仪及脉搏血氧饱和度仪分别监测两组病人治疗前后的PaO2 、SaO2 、PaCO2 、呼吸率及心率的变化。结果 :治疗后BiPAP组PaO2 、SaO2 较对照组显著提高 ,而PaCO2 、呼吸率及心率显著下降 ,两组间比较各项指标均有显著性差异 (P <0 0 1 ,P <0 0 1 ,P <0 0 1 ,P <0 0 5 ,P <0 0 5 )。结论 :BiPAP通气治疗能显著改善COPD呼衰患者的缺氧并降低二氧化碳分压 。

Objective:To assess the effect of bilevel positive airway pressure(BiPAP) ventilation in patients with chronic obstructive pulmonary disease(COPD)who suffered from acute respiratory failure of type two.Methods:PaO 2,SaO 2,PaCO 2,respiratory rate and heart rate of all patients were monitored by blood gas analyzer and pulse oximetry before and after treatment.Under the same routine therapy,these patients were divided into two groups:21 cases of contral group with oxygen therapy via a nasal tube and 25 cases of BiPAP system group with BiPAP ventilation via a nasal or face mask.Results:In the BiPAP system group there were a significantly increased in PaO 2 and SaO 2(P<0.01) but remakablly decreased in PaCO 2,respiratory rate and heart rate (P<0.01,P<0.05,P< 0.05 )compared with the contral group after treatment.Conclusion:This study demonstrates that BiPAP ventilation can remakablly improve PaO 2,SaO 2 and PaCO 2 in respiratory failure of patients with COPD,especially in releasing anoxia,the effect is more favorable. [