无创正压通气治疗慢性阻塞性肺疾病致肺性脑病的临床观察

Clinical outcomes of non-invasive positive pressure ventilation for chronic obstructive pulmonary disease with pulmonary encephalopathy

目的:评价应用无创正压通气治疗慢性阻塞性肺疾病导致肺性脑病的临床效果。方法:采用回顾性研究方法,观察68例COPD导致呼吸衰竭患者使用双水平无创呼吸机辅助通气,动态观察比较治疗前和治疗后动脉血气及相关临床指标。结果:68例患者中有50例治疗好转后出院,8例需要行气管插管机械通气,10例放弃治疗,有效率为73.53%。结论:无创正压通气对部分慢性阻塞性肺疾病致肺性脑病的治疗有效,临床可酌情扩大无创正压通气的适应证,合理使用可避免早期气管插管机械通气治疗。

Objective：To evaluate the efficacies of non-invasive positive pressure ventilation （NIPPV） in treatment of chronic obstructive pulmonary dis-ease （COPD） complicated with pulmonary encephalopathy.Methods：A retrospective study was performed in 68 COPD patients with respiratory failure un-dergone NIPPV,and the arterial blood gas and related clinical indicators before and after treatment were dynamically observed and compared .Results：In the 68 cases,50 were recovered,8 required endotracheal intubation with mechanical ventilation,and 10 subjectively quitted the treatment.The effective rate was 73.53%.Conclusion：NIPPV can be effective for major COPD patients with pulmonary encephalopathy .Yet rational considerations shall be taken if it is applied to wider indications in order to eliminate early tracheal intubation and mechanical ventilation .