无创正压通气在慢性阻塞性肺疾病合并肺性脑病时的应用研究

Effect of noninvasive bi level positive airway pressure ventilation in COPD with pulmonary encephalopathy

目的 研究慢性阻塞性肺疾病 (COPD)患者合并肺性脑病时进行无创双水平正压通气 (BiPAP)的效果。方法 6 4例COPD合并肺性脑病患者分为BiPAP组和气管插管机械通气 (ETI-MV)组 ,观察两组的治疗效果。结果 两组患者在存活率方面无显著差异 ;与BiPAP组比较 ,ETI-MV组在治疗 4小时后 ,呼吸衰竭得以纠正 ,但住院期间的严重并发症却明显增多 ,住院时间也明显延长。结论 对于COPD合并肺性脑病患者 ,如果自主呼吸尚可 ,能够耐受BiPAP治疗 ,应先试用Bi PAP ,不要急于应用ETI-MV。

Objective To study the effect of noninvasive bi level positive airway pressure(BiPAP) ventilation in COPD patients with pulmonary encephalopathy.Methods 64 COPD patients with pulmonary encephalopathy were divided into BiPAP group and endotracheal intubation mechanical ventilation (ETI MV)group The effects of the treatments were investigated Results NO significant difference was found in the survival rates of these two groups Compared with BiPAP group,the situation of the patients in ETI-MV group was improved soon after they were treated,as well as the complications of ETI-MV increased The hospital stay of ETI-MV group was longer than that of BiPAP group.Conclusion To the COPD patients with pulmonary encephalopathy whom have stable autonomous respiration,BiPAP can be successfully used if they can tolerate it,however ETI MV is not suitable for being first-line intervention at that circumstance [