高强度无创正压通气对COPD合并Ⅱ型呼吸衰竭患者的临床疗效与安全性分析

Clinical effect and safety analysis of high-intensity no-invasive positive pressure ventilation in the treatment of COPD patients complicated with type Ⅱ respiratory failure

目的探讨并比较高强度和低强度无创正压通气治疗慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭的临床效果和安全性。方法将96例COPD合并Ⅱ型呼吸衰竭患者随机分为高强度组和低强度组,每组各48例,观察各组患者经无创正压通气治疗前后临床症状和气血分析的变化。结果高强度组经无创正压通气治疗2、24 h后动脉血氧分压(PaO2)、pH值较低强度组高,动脉血二氧化碳分压(PaCO2)、心率(HR)、呼吸频率(RR)较低强度组低,通气状况改善更明显,不良反应无明显增加。结论高强度无创正压通气较低强度组可更为迅速可靠地改善通气,显著改善PaO2、PaCO2、pH、RR和HR,减少了气管插管或气管切开的危险因素,降低死亡率,改善预后,提高患者的依从性。

Objective To discuss and compare the curative effect and safety analysis of high and low intensity no-in-vasive positive pressure ventilation in the treatment of COPD patients complicated with type Ⅱ respiratory failure. Methods 96 cases of COPD patients complicated with type Ⅱ respiratory failure were randomly divided into the high intensity group and the low intensity group,48 cases in each group,the clinical effect and blood gas analysis were ob-served in each group before and after ventilation. Results The levels of PaO2 and pH increased more significantly and the levels of PCO2,HR and RR decreased more significantly in the high intensity group than those of the low intensity group after two and twenty four hours ventilation.At the same time the ventilation status was improved more obviously, however there was no obvious adverse reaction increasing between the two groups.Conclusion The high intensity group can improve the ventilation,PaO2,PCO2,pH,RR,HR more rapidly and reliably,reduce the hazards of tracheal intubation and tracheotomy,and reduce the rate of mortality,improve the prognosis than the low intensity group without different compliance.