无创呼吸机治疗慢性阻塞性肺疾病急性加重合并Ⅱ型呼吸衰竭52例临床分析

Clinical analysis of 52 cases acute exacerbation of chronic obstructive pulmonary disease complicated by type Ⅱ respiratory failure treated by non-invasive ventilator

目的探讨无创呼吸机双水平正压通气(Bi PAP)治疗慢性阻塞性肺疾病(COPD)急性加重期(AECOPD)合并Ⅱ型呼吸衰竭的临床效果。方法选取2013年1月~2016年6月我院收治的52例AECOPD患者临床资料进行分析,随机分为对照组和观察组,每组26例。对照组采取常规治疗,观察组在此基础上联合无创呼吸机治疗,比较两组患者治疗前后动脉血气分析、呼吸频率、心率指标的变化。结果两组患者治疗后动脉血p H值、动脉血氧分压(PaO_2)明显升高,动脉二氧化碳分压(PaCO_2)明显降低,且观察组变化更为显著,差异有统计学意义(P<0.05)。两组患者治疗后呼吸频率、心率明显减慢,且观察组变化更为明显,差异有统计学意义(P<0.05)。结论对于AECOPD合并Ⅱ型呼吸衰竭的患者,在常规治疗的基础上增加无创呼吸机的辅助治疗,临床效果显著,方便实用,值得临床推广。

Objective To explore the clinical effect of bi-level positive airway pressure（Bi PAP）with non-invasive ventilator in treating acute exacerbation of chronic obstructive pulmonary disease（AECOPD） complicated by typeⅡ respiratory failure.Methods The clinical data of 52 cases of AECOPD patients in our hospital from January 2013 to June2016 were selected to conduct the research,they were devided into two groups,patients in observation group were treated with non-invasive ventilator,with routine treatment in control group.Blood gas analysis,respiratory rate and heart rate before ana after treatment between two groups were compared.Results After treatment,artery blood p H and arterial partial pressure of oxygen was significantly higher,arterial partial pressure of carbon dioxide significantly decreased,and more significantly changes in the observation group,there was significant difference（P〈0.05）.After treatment,respiratory rate,heart tate significantly decreased,and more significantly changes in the observation group,there was significant difference（P〈0.05）.Conclusion On the basis of conventional treatment,non-invasive ventilator treatment for elderly patients with AECOPD complicated by type Ⅱ respiratory failure has a significant clinical effect,and it is convenient,practical,worthy of clinical application.