无创机械通气在COPD急性加重期合并Ⅱ型呼吸衰竭患者的临床研究

Clinical research of noninvasive positive pressure ventilation in acute exacerbation of chronic obstructive pulmonary disease with type Ⅱ respiratory failure

目的:探讨无创机械通气(noninvasive positive pressure ventilation,NIPPV)对慢性阻塞性肺疾病急性加重期(acute exacerbations of chronic obstructive pulmonary disease,AECOPD)合并Ⅱ型呼吸衰竭患者的临床价值。方法:选择AECOPD合并Ⅱ型呼吸衰竭患者90例,分为NIPPV组和常规治疗组。对两组治疗前及治疗后1 h、24 h、72 h血气分析、呼吸频率(breathing rate,RR)进行比较。结果:NIPPV组与常规治疗组内各时间点比较,各项指标均有差异(P<0.05);治疗后1 h NIPPV组患者PCO2、pH值与对照组比较无明显变化(P>0.05),治疗后24 h及72 h NIPPV组患者pH值与对照组比较无明显变化(P>0.05);其余时间点各项指标均优于常规治疗组(P<0.05)。结论:无创机械通气对AECOPD合并Ⅱ型呼吸衰竭患者有确切的临床疗效,且疗效优于常规治疗组。

Objective：Evaluate the clinical value of NIPPV（ noninvasive positive pressure ventilation） in AECOPD （acute exacerbations of chronic obstructive pulmonary disease） with type Ⅱ respiratory failure. Methods：90 cases of AECOPD patients with type Ⅱ respiratory failure were divided into two subgroups,and one group received NIPPV treatment and the matched group received conventional treatment. The blood gas analysis and respiratory frequency were taken before and after treatment,respectively. Results：The partial pressure of oxygen（ PO2 ）, the potential of hydrogen and the respiratory frequency value in the patients one hour after the NIPPV treatment significantly improved（ P 〈 0.05 ） , and the partial pressure of carbon dioxide（ PCO2 ） was lower（ P 〉 0.05 ）. Only the partial pressure of oxygen 1h after the NIPPV treatment was significantly superior to conventional treatment（ P 〈 0. 05 ）. However,24 hours and 72 hours after the NIPPV treatment, all the indexes such as the blood gas analysis,respiratory frequency were improved. It is also significantly superior to conventional treatment（P 〈 0. 05）. Conclusion：NIPPV treatment is more reliable and effective in treating AECOPD patients with type Ⅱ respiratory failure than conventional treatment.