BiPAP无创通气治疗COPD急性加重合并Ⅱ型呼吸衰竭的临床观察

Clinical Observation of BiPAP Noninvasive Ventilation Acute Exacerbations of COPD Ⅱ Respiratory Failure

目的观察BiPAP无创正压通气治疗慢性阻塞性肺疾病急性加重期(AECOPD)合并Ⅱ型呼吸衰竭临床疗效。方法 48例AECOPD合并Ⅱ型呼吸衰竭住院患者随机分为常规治疗组(对照组)26例和BiPAP无创通气治疗组(治疗组)22例,对照组仅给予持续低流量吸氧、抗感染、支气管扩张剂、祛痰、抗炎等治疗;治疗组在对照组的治疗基础上,联合BiPAP无创正压通气;观察2组患者治疗前后动脉血气、呼吸频率、心率的变化。结果两组患者在治疗后动脉血气(pH值、PaCO2、PaO2)、呼吸频率和心率与治疗前比较均有明显改善,治疗组在降低二氧化碳分压(PaCO2)、提高氧分压(PaO2)、改善pH值、呼吸频率和心率方面较对照组患者效果更明显,差异有统计学意义(P<0.05)。结论联合BiPAP无创正压通气可有效改善AECOPD合并Ⅱ型呼吸衰竭患者的动脉血气及生命体征,可更有效改善患者病情,提高治疗有效率。

Objective To investigate the treatment of BiPAP noninvasive positive pressure ventilation on chronic obstructive pulmonary disease with acute exacerbation （AECOPD）combined with typeⅡ respiratory failure.Methods 48 cases of AECOPD combined typeⅡ respiratory failure hospitalized patients were randomly divided into the conventional treatment group （control group） in 26 cases and BiPAP noninvasive ventilation group （treatment group） in 22 cases. Control group were given continuous low lfow oxygen, anti-inlfammatory, bronchodilator, expectorant drugs, corticosteroids and other therapy, and the BiPAP noninvasive positive pressure ventilation was added to the treatment group. The two groups were observed with arterial blood gas, respiratory rate, heart rate, changes before and after treatments.Results After treatment, arterial blood gas （pH value, PaCO2, PaO2）, respiratory rate and heart rate of the treatment and control groups were signiifcantly improved compared with before treatment. Treatment group is more effective to reduce carbon dioxide partial pressure （PaCO2）, increased partial pressure of oxygen （PaO2）, to improve the pH, respiratory rate and heart rate than the control group,difference was statistically signiifcant （P〈0.05）.Conclusion The using of BiPAP Noninvasive positive pressure ventilation can improve arterial blood gas and vital signs of AECOPD combined typeⅡ respiratory failure patients, which improve the patient＆#39;s condition and enhance the treatment efifciency.