无创正压通气治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭临床分析

Clinical analysis of noninvasive positive pressure ventilation (NIPPV) to treat chronic obstructive pulmonary disease combined with type-Ⅱ respiratory failure

目的对无创正压通气治疗慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭临床治疗效果进行探讨和分析。方法将山东省青岛工人疗养院2008-01—2015-01行无创正压通气治疗COPD合并Ⅱ型呼吸衰竭患者32例设为观察组,同时选择同期行治疗的COPD合并Ⅱ型呼吸衰竭患者26例设为对照组。比较和分析两组患者血气分析治疗前后各项观察指标的变化情况及不良反应情况。结果观察组治疗后p H、Pa O2、Pa CO2、HR、RR均较对照组治疗后有明显改善,差异有统计学意义(P<0.05);观察组治疗后无效6例,占18.75%(6/32),明显少于对照组无效例数(12/26,占46.15%),观察组的总有效率达81.25%,与对照组的53.85%比较差异有高度统计学意义(P<0.01)。结论应用无创正压通气治疗COPD合并Ⅱ型呼吸衰竭疗效确切。

Objective To explore and analyze the clinical effects of noninvasive positive pressure ventilation in the treatm ent of chronic obstructive pulm onary disease （C O PD ） com bined w ith type-II respiratory failure.Methods 32 patients w ith C O PD com bined w ith type-II respiratory failure at Q ingdao W orkers＇ Sanatorium from January 2008 to January 2015 undergoing noninvasive positive pressure ventilation w ere established as an observation group ,and 26 patients w ith C O PD com bined w ith type-Ⅱ respiratory failure undergoing treatm ent in the corresponding period w ere established as a control group .The blood gas analysis changes before and after the treatm ent and adverse occurrence between the two groupswere compared and analyzed.Results The pH,PaO2,PaCO2,HR,and RR ofthe observation group after treatm ent im proved significantly com pared w ith those of the control group ,and the differences w ere of statistical significance（P〈0.05）.A fter treatm ent,6 cases in the observation group w ere invalid,accounting for 18.75%（6/32 ）,w hich w ere significantly low er than the control group （12/26 ,accounting for 46 .15% ）.The total effective rate of the observation group w as 81 .25% ,com pared w ith 53 .85% of the control group ,the differences w ere of high statistical significance （P〈0.01）.Conclusion N oninvasive positive pressure ventilation to treat C O PD com bined w ith type-Ⅱrespiratory failure has definite therapeutic effects.