双水平正压无创机械通气治疗慢性阻塞性肺病合并Ⅱ型呼吸衰竭的应用效果

Application effect of bilevel non-invasive mechanical ventilation in the treatment of chronic obstructive pulmonary disease combined with typeⅡ respiratory failure

目的探讨双水平正压无创机械通气治疗慢性阻塞性肺病合并Ⅱ型呼吸衰竭的效果。方法选择2010年1月～2013年12月因慢性阻塞性肺病急性加重致Ⅱ型呼吸衰竭人院的患者134例，随机分为观察组和对照组，每组67例，对照组按常规给予综合治疗，观察组在常规治疗基础上行无创通气治疗，观察两组治疗前后心率（HR）、呼吸频率（RR）、动脉血气结果及峰值呼气流速（PEF）改善情况。结果两组治疗72h后的pH、PaO2较治疗前增加，PaCO2较治疗前降低，差异有统计学意义（P〈0．05）；与对照组比较，观察组改善更为明显（P〈0．05）。两组治疗72h后的RR、HR均较治疗前降低（P〈0．05）；观察组治疗72h后的RR、HR下降较对照组明显（P〈0．05）。两组治疗72h后的PEF较治疗前增加，观察组治疗72h后的PEF增加较对照组明显（P〈0．05）。结论采用双水平正压无创机械通气治疗慢性阻塞性肺病合并Ⅱ型呼吸衰竭，可显著改善患者的血气分析结果、HR、RR及PEF水平，明显改善患者的气道阻塞情况，是一种安全、有效的治疗方法。

Objective To discuss the effects of bilevel non-invasive mechanical ventilation in the treatment of chronic obstructive pulmonary disease with type Ⅱ respiratory failure. Methods 134 cases of patients with type Ⅱ respiratory failure due to acute exacerbation of chronic obstructive pulmonary disease from January 2010 to December 2013 were selected and randomly divided into observation group and control group,67 cases in each group,the control group received conventional comprehensive treatment,the observation group received non-invasive ventilation therapy base on the routine treatment.The heart rate（HR）,respiratory rate（RR）and arterial blood gas index change before and after treatment and peak expiratory flow （PEF）rate improvement in two groups was observed respectively. Results Compared with before treatment,pH,PaO2 of two groups after treatment of 72 hours was significantly increased respectively,while PaCO2 was significantly decreased,with statistical difference（P〈0.05）.Compared with control group,the improvement in observation group was more significantly （P〈0.05）.Compared with before treatment,HR,RR in two groups after treatment of 72 hours was significantly decreased respectively,with statistical difference （P〈0.05）.Compared with control group,observation group decreased more significantly,with statistical difference （P〈0.05）.Compared with before treatment,PEF in two groups after treatment of 72 hours was＇ significantly increased,observation group increased more significantly （P〈0.05）. Conclusion Bilevel non-invasive mechanical ventilation in the treatment of chronic obstructive pulmonary disease combined with type Ⅱ respiratory failure can significantly improve the result of blood gas analysis,HR,RR and PEF level,improve the patient＇s airway obstruction,and is a safe,effective treatment method.