基层医院使用BIPAP治疗AECOPD合并Ⅱ型呼衰的疗效观察

Curative Effect Observation of Basic Hospitals Use BIPAP Treatment of COPD with Type Ⅱ Respiratory Failure

目的探讨用双水平无创正压通气(BIPAP)在治疗慢性阻塞性肺疾病急性加重(AECOPD)合并Ⅱ型呼吸衰竭,与常规呼吸内科治疗的疗效对比。方法方便选取该院2014年1月—2015年1月收治的50例AECOPD合并Ⅱ型呼吸衰竭患者的临床资料进行回顾性分析,分为治疗及对照两组,每组25例患者,在常规治疗(抗感染、化痰、平喘)一致下,治疗组加用双水平无创正压通气(BIPAP)治疗,1周为一个治疗阶段,观察患者治疗前后的症状体征以及血气分析情况,并与对照组做统计学分析。结果治疗1周后,BIPAP治疗组Pa O_2、Sa O_2明显增高(P<0.05),心率、呼吸、PaCO_2明显降低(P<0.05)。BIPAP治疗组患者治疗后与对照组治疗后在临床症状、体征(呼吸、心率减慢,P值均<0.05)及血气分析各项指标(PH升高、Pa O_2升高、Sa O_2升高、Pa CO_2下降,P<0.05),差异有统计学意义。结论用BIPAP治疗AECOPD合并Ⅱ型呼吸衰竭疗效确切。

Objective To compare the therapeutic effect of acute exacerbation of chronic obstructive pulmonary disease（AECOPD） with type Ⅱ respiratory failure by Bi level noninvasive positive pressure ventilation（BIPAP） and Conventional respiratory department of Internal Medicine. Methods Convenient selection the clinical data of 50 patients with AECOPD complicated with type Ⅱ respiratory failure admitted to our hospital from January 2014 to January 2015 were analyzed.retrospectively.Treatment and control were divided into two groups, 25 patients in each group,In the conventional treatment（anti infective, phlegm and relieving）. The treatment group treated with bi level noninvasive positive pressure ventilation（BiPAP） treatment, 1 week for a period of treatment were observed before and after treatment in patients with symptoms and signs and blood gas analysis and compared with the control group to do statistical analysis. Results After 1 weeks of treatment, BIPAP treatment group, signs Pa O_2 increased, Sa O_2increased（P〈0.05）,besides respiration, heart rate slows down and Pa CO_2decreased（P〈0.05）.BIPAP treatment group and control group after treatment in clinical symptoms, signs（respiration, heart rate slows down. P〈0.05） and blood gas analysis index（PH in creaced）, Pa O_2 increased, Sa O_2 increased, Pa CO_2decreased（P〈0.05）. haverg statistical significance.Conclusion The treatment of AECOPD with type Ⅱ respiratory failure with BIPAP is effective.