无创机械通气治疗Ⅱ型呼吸衰竭32例临床研究

Clinic study of non-invasive positive pressure ventilation on 32 patients with type Ⅱ respiratory failure

目的探讨无创机械通气(NIPPV)在治疗Ⅱ型呼吸衰竭患者中的临床应用意义。方法将60例Ⅱ型呼吸衰竭患者分为治疗组与对照组。治疗组32例,在药物治疗的基础上给予无创机械通气;对照组28例,给予药物治疗,鼻导管吸氧;两组患者如上述治疗无效则采用气管插管行有创机械通气治疗。对比两组患者在治疗前后的氧分压(PO2)、二氧化碳分压(PCO2)、血氧饱和度(SpO2)、插管率及总住院时间。结果经治疗后两组患者动脉血PO2及SpO2较治疗前均有显著改善(P<0.05),而治疗后治疗组的动脉PCO2较对照组显著降低(P<0.05),PO2显著升高(P<0.05),治疗组患者的插管率、总住院时间均显著低于对照组(P<0.05)。结论 NIPPV在救治Ⅱ型呼吸衰竭时可以明显改善患者血气指标,降低PCO2,减轻患者的痛苦,缩短住院时间。

Objective To investigate the clinical application of non-invasive positive pressure ventilation （NIPPV） to patients with type Ⅱ respiratory failure. Methods A total of 60 patients with type Ⅱ respiratory failure were divided into two groups at random, i. e. trial group （n = 32） treated with NIPPV in addition to drugs, and control group （n = 28 ） treated with drugs and oxygen inhalation via nasal catheter. The patients would be given invasive mechanical ventilation via intubation if the above treatment failed. The patients＇ PO2. PCO2 , SpO2 ,intubation rate, and total time length of stay in hospital, were contrasted. Results Patients＇ PO2 and SpO2 increased significantly after treatment in two groups（ P 〈 0.05 ）. Patients＇ PCO2 was significantly decreased after treatment in the trial group（ P 〈 0.05 ）. Patients＇ PO2 in the trial group increased significantly contrasted with that in the control group（ P 〈 0.05 ）. And patients＇ intubation rate, total time length of stay in hospital in the trial group decreased significantly contrasted with that in the control group（P 〈 0.05 ）. Conclusion In clinical treatment for type Ⅱ respiratory failure, NIPPV can not only improve the patients＇ PCO2 and life quality but also decrease the mortality and the hospitalization time.