高频喷射通气治疗慢性阻塞性肺疾病呼吸衰竭的疗效

High frequency jet ventilation efficacy for the treatment of respiratory failure of COPD

目的探讨高频喷射通气治疗慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭的治疗效果。方法将152例COPD合并Ⅱ型呼吸衰竭患者随机分为高频喷射通气(HFJV)组和双水平气道正压通气(Bi PAP)组。在常规治疗的基础上,HFJV组采用鼻导管连接双向高频喷射通气治疗,Bi PAP组采用口鼻面罩连接双水平正压通气治疗。同时,观察两组患者临床症状、心率、呼吸频率、血气分析等指标以评估疗效。结果 HFJV组和Bi PAP组的治疗有效率分别为85.5%和88.2%,死亡率分别为5.26%和3.95%,两组间比较差异均无统计学意义(P>0.05)。治疗后,两组患者心率、呼吸频率、血气分析等指标均较治疗前有明显改善(P<0.05)。结论高频喷射通气是一种操作简单易行的无创通气方式,治疗COPD合并Ⅱ型呼吸衰竭可获得良好的效果,且通气时间和住院时间更短。

Objective To explore the high frequency jet ventilation efficacy for the treatment of type Ⅱ respiratory failure of COPD. Methods Totally 152 cases of COPD with type Ⅱ respiratory failure patients were randomly assigned into high frequency jet ventilation（HFJV） group and bi-level positive airway pressure ventilation （BiPAP）group. On the basis of conventional treatment, patients in HFJV group were treated by high frequency jet ventilation connected by nasal catheter, and BiPAP group with bi-level positive airway pressure ventilation therapy connected by nasal-mouth mask. After that,observation of clinical symptoms,heart rate, breathing rate, blood gas analysis index was performed to evaluate the curative effects. Results For HFJV and BiPAP group, effi- ciency was achieved at 85.5% and 88.2% ,and the mortality rate were 5.26% and 3.95% respectively. While,there was no sig- nificant difference between the two groups（ P 〉 0.05 ）. After treatment, heart rate, breathing rate, blood gas analysis index were im- proved significantly in patients of both groups（ P 〈 0.05 ）. Conclusion As a kind of easy performing and non-invasive approach, high frequency jet ventilation connected by nasal catheter can achieve good curative effect in the treatment of type Ⅱ respiratory fail- ure of COPD,with shorter aeration time and shorter hospitalization time.