无创双水平气道正压通气辅助治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭43例临床分析

Clinical analysis of noninvasive bi-level positive airway pressure in COPD complicated with type Ⅱ respiratory failure

目的观察无创双水平气道正压通气(BiPAP)辅助治疗慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭的疗效。方法将我院RICU的84例COPD合并Ⅱ型呼吸衰竭患者,随机分为无创通气组和常规治疗组。两组均予常规药物治疗。无创组辅以BiPAP无创通气,常规组予鼻导管吸氧,观察治疗2 h前后动脉血气的变化及无创通气对患者插管率的影响。结果相对于常规治疗组,BiPAP无创通气2 h可有效纠正呼吸性酸中毒,降低PCO2,提高PO2,降低插管率(P均<0.05)。结论 BiPAP无创通气可缓解COPD合并Ⅱ型呼吸衰竭患者呼吸困难,改善血气,降低气管插管率。

Objective To observe the therapeutic effects of noninvasive bi -level positive airway pressure （BiPAP） ventilation on chronic obstructive pulmonary disease（COPD） complicated with type Ⅱ respiratory failure patients. Methods Eighty - four cases of COPD complicated with type Ⅱ respiratory failure in our hospital RICU were randomly divided into the noninvasive group and the conventional group. Besides routine drug therapy, 43 cases in the noninvasive group were administered with BiPAP ventilation, other 41 cases in the conventional group were administered with oxygen inhalation through nasal catheter. The changes of arterial blood gas, reintubation rate were observed in the two groups. Results Compared with the conventional group, the noninvasive group had better blood gas improvement and lower reintubation rate after 2 hours of noninvasive ventilation （P 〈 0. 05）. Conclusion The noninvasive BiPAP ventilation can relieve the syndrome of dyspnea, improve blood gas and lower reintubation rate for COPD complicated with type Ⅱ respiratory failure cases.