无创机械通气治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的疗效观察

Efficacy of noninvasive mechanical ventilation in the treatment of chronic obstructive pulmonary disease with type Ⅱ respiratory failure

目的探讨无创机械通气治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的疗效。方法 2009年6月～2012年6月间我院应用无创机械通气治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭36例,另选择同期行常规对症支持治疗的32例慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者设立为对照组,比较两组治疗前及治疗后72 h动脉血气分析(pH,PaO2,PaCO2)、呼吸频率(RR)、心率(HR)的变化。结果观察组和对照组患者治疗后的PaO2、pH值均较治疗前明显升高,且观察组的PaO2较对照组升高更显著,差异有统计学意义(P<0.05)。而观察组和对照组患者治疗后的PaCO2、RR、HR均较治疗前明显降低,且观察组PaCO2、RR、HR较对照组降低更显著,差异有统计学意义(P<0.05)。结论无创机械通气治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭操作简单,疗效确切,值得广泛推广和应用。

Objective To investigate the efficacy of noninvasive mechanical ventilation in the treatment of chronic ob- structive pulmonary disease with type Ⅱ respiratory failure. Methods From June 2009 to June 2012 in our hospital without invasive mechanical ventilation in the treatment of chronic obstructive pulmonary disease merger type Ⅱrespi- ratory failure in 36 cases, and other selected underwent conventional symptomatic and supportive treatment of 32 cases of chronic obstructive pulmonary disease merger 72 h before and after treatment in patients with type Ⅱ respiratory failure was established as a control group, compared treatment of arterial blood gas analysis （pH, PaO2, PaCO2）, respira- tory rate （RR）, heart rate （HR） changes. Results The observation group and control group patients after treatment PO2, pH values than those before treatment was significantly higher, and PO2 of the observation group compared with the control group increased more significantly, there was a statistically significant difference （P 〈 0.05）. PaCO2, RR, HR observation group and control group patients after treatment than before treatment significantly reduced PaCO2, RR, HR of the observation group than in the control group decreased more significantly, there was a statistically significant difference （P 〈 0.05）. Conclusion Noninvasive mechanical ventilation in the treatment of chronic obstructive pul- monary disease with type Ⅱ respiratory failure is simple and effective, and should be popularized and applied.