经面罩BIPAP无创通气与有创通气对COPD呼吸衰竭患者院内治疗结局的影响

Effects of noninvasive ventilation and invasive ventilation on COPD respiratory failure in patients with BIPAP respiratory failure by mask

目的研究经面罩BIPAP无创通气与有创通气对COPD呼吸衰竭患者院内治疗结局的影响。方法选取我院2012年4月至2014年4月60例COPD呼吸衰竭患者为研究对象抽签随机分为2组,有创通气组和无创通气组,每组30例。在常规治疗的基础上,有创通气组给予气管插管呼吸机辅助呼吸,无创通气组给予面罩呼吸机辅助呼吸。比较治疗前与治疗后24h后两组患者治疗指标。结果无创通气组和有创通气组治疗前基础临床无统计学意义(P>0.05),治疗后24h观察到两组患者的动脉血气指标PH、动脉血氧分压(Pa O2)含量升高,动脉血二氧化碳分压(Pa CO2)含量下降,有统计学意义(P<0.05)。治疗后24h血浆脑钠肽(BNP)含量均有下降,有创通气组更加显著(有创组161.02±50.22,无创组67.04±5.07,t=3.54),有统计学意义(P<0.05)。结论经面罩BIPAP无创通气与有创通气对COPD呼吸衰竭患者院内治疗均有积极影响,有创通气相对于无创通气治疗效果更为显著。

Objective To study the effect of BIPAP noninvasive ventilation and invasive ventilation on the outcome of COPD patients with respiratory failure in patients with respiratory failure. Method In our hospital from April 2012 to April 2014, 60 cases of COPD patients with respiratory failure were randomly divided into 2 groups, there were 30 cases in each group, there were cases in each group. On the basis of routine treatment, the invasive ventilation group was treated with endotracheal intubation and assisted breathing. Compared before and after the treatment of 24 h after treatment in two groups index. Result Noninvasive ventilation group and noninvasive ventilation in the treatment group of clinical had no statistical significance（P〈0.05）, after treatment observed 24 h to two groups of patients with arterial blood gas index p H, arterial oxygen partial pressure（Pa O2） content increased, arterial carbon dioxide partial pressure（Pa CO2） content decreased, there is statistical significance（P〈0.05）. 24 h after treatment of plasma brain natriuretic peptide（BNP） levels were decreased, the invasive ventilation group was more significantly（a group of 161.02 ＋ 50.22, 67.04 ＋ 5.07 noninvasive group, t=3.54）, there was statistical significance（P〈0.05）. Conclusion Noninvasive ventilation and invasive ventilation on COPD in patients with BIPAP respiratory failure had positive effects on the treatment of patients with respiratory failure, and there was a more significant effect on invasive ventilation compared with noninvasive ventilation.