无创通气对重度Ⅱ型呼吸衰竭患者炎性指标及预后的影响

Influence of noninvasive bilevel positive airway pressure on the level of inflammatory factors and prognosis of the patients with servere type Ⅱ respiratory failure

目的观察无创BIPAP呼吸机对慢性阻塞性肺疾病急性加重合并重度Ⅱ型呼吸衰竭患者的炎性指标及预后的影响。方法对61例慢性阻塞性肺疾病急性加重合并重度Ⅱ型呼吸衰竭的患者采用无创BIPAP呼吸机通气治疗。按照动脉血氧分压(PaCO_2)水平将患者分为3组,观察治疗前后血气分析指标及C反应蛋白、APACHEⅡ评分、降钙素原的变化,并比较各组治疗有效率。结果 3组使用BIPAP呼吸机辅助通气治疗7 d后PaO_2明显升高,动脉血二氧化碳分压(PaCO_2)明显降低,pH明显改善,C反应蛋白、降钙素原及APACHEⅡ评分也均有改善,总有效率为81.9%。结论无创BIPAP呼吸机通气对重度Ⅱ型呼吸衰竭疗效显著,并可以显著降低炎性指标,改善预后。

Objective To investigate the effects noninvasivebilevel positive airway pressure（ BIPAP） ventilator on the level of inflammatory factor and prognosis of the patients with acute exacerbations of chronic obstructive pulmonary（ AECOPD） complicated with severe typeⅡrespiratory failure. Methods The 61 patients with AECOPD complicated with severe typeⅡ respiratory failure received noninvasive BIPAP assisted ventilation. These cases were divided into three groups by the level of PaCO_2. The levels of the indicators of arterial blood gas analysis,C reactive protein（ CRP）,APACHEⅡscore and procalcitonin were compared between the groups. The effective rate was also compared between the three groups. Results The level of PaO_2 was increased significantly,the level of PaCO_2 decreased significantly,pH,CRP and APACHE Ⅱscore significantly improved 7 days after the treatment of noninvasive Bi PAP mechanical ventilation.The total effective rate was 81. 9%. Conclusions The inflammatory factor could be decreased and the respiratory function could be improved in the patients with servere type Ⅱ respiratory failure due to COPD treated by noninvasive Bi PAP mechanical ventilation.