双水平无创正压通气应用于慢性阻塞性肺疾病合并呼吸衰竭患者72h疗效观察

The 72 hours' s clinical effect observation on bilevel positive airway pressure ventilation in the patients of chronic obstructive pulmonary disease complicated with respiratory failure

目的探讨双水平无创正压通气(bilevel positive airway pressure ventilation,BiPAP)对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)合并呼吸衰竭患者的早期临床疗效。方法根据是否给予BiPAP,将120例入选患者分为治疗组与对照组。分析两组患者的动脉血气及生命体征,观察有无不良反应发生,并比较两组患者的转归。结果①经治疗同时间点酸碱度(power of hydrogen,pH)、动脉血氧分压(arterial partial pressure of oxygen,PaO2)、动脉血二氧化碳分压(partial pressure of arterial carbon dioxide,PaCO2)、动脉血氧饱和度(arterial oxygen saturation,SaO2)、心率(heart rate,HR)、呼吸频率(resparitory rate,RR)治疗组明显优于对照组,且两组间疗效差异均具有统计学意义(P<0.05)。②治疗组有不良反应出现,但都能配合与耐受,对照组均未出现明显不良反应。③治疗组有效率明显高于对照组(P<0.05)。结论 BiPAP治疗COPD合并呼吸衰竭疗效确切、耐受性好,能有效改善预后,是一种行之有效的治疗方法,应予早期应用。

Objective To explore the effect of bilevel positive airway pressure ventilation （BiPAP） on chronic obstructive pulmonary disease （COPD） complicated with respiratory failure. Methods According to whether or not giving Bi- PAP, all of 120 patients selected were divided into treatment group and control group. Arterial blood gas of the two groups, observed the adverse reactions were analyzed and outcomes of the two groups were compared. Results （1）The treatment group＇s power of hydrogen（pH）, arterial partial pressure of oxygen（PaO2）, partial pressure of arterial carbon dioxide（PaCO2）, arterial oxygen saturation（SaO2）, heart rate（HR） and resparitory rate（RR）at the same time after treatment were better than control group, and the differences of the curative effect were significant （P〈0.05）. （2）The treat- ment group had adverse reactions to appear, but can cooperate and tolerance, the control group had no obvious ad- verse reaction occurred. （3）The effective rate of treatment group was obviously significantly higher than that of control group （P〈0.05）. Conclusion BiPAP is an effective treatment method on COPD complicated with respiratory failure, easy to tolerance, and can effectively improve the prognosis, should be early applicated.