BiPAP呼吸机不同使用时间对Ⅱ型呼吸衰竭患者血气指标和呼吸功能的影响

Influence of different use time of BiPAP ventilator on blood gas indicators and respiratory function in patients with type Ⅱ respiratory failure

目的观察双水平气道正压(BiPAP)呼吸机不同使用时间对Ⅱ型呼吸衰竭患者血气指标、呼吸功能的影响。方法选择2014年2月至2016年2月该院收治的52例Ⅱ型呼吸衰竭急性加重期患者作为研究对象,按照随机数字表法分为观察组和对照组,每组各26例。两组患者均给予常规抗感染、平喘、祛痰、氧疗、支气管扩张、呼吸兴奋剂、糖皮质激素等治疗。对照组使用BiPAP呼吸机4h,观察组使用BiPAP呼吸机8h。观察两组患者治疗前后血气指标、呼吸频率(RR)、心率(HR)及平均动脉压(MAP)变化情况,比较两组患者治疗7d后睡眠质量指标变化情况及不良反应发生情况。结果与对照组比较,观察组治疗后血氧分压、血氧饱和度、pH值明显提高,二氧化碳分压、RR、HR、MAP显著降低(P<0.05);两组患者治疗7d后,观察组睡眠质量明显优于对照组(P<0.05);两组患者在治疗过程中发生胃胀气、皮肤损伤及耳内不适不良反应情况比较,差异无统计学意义(P>0.05)。结论延长BiPAP呼吸机通气时间能有效改善Ⅱ型呼吸衰竭患者血气指标及呼吸功能,值得临床推广。

Objective To observe the influence of different use time of BiPAP ventilator on blood gas indicators and respiratory function in patients with typeⅡ respiratory failure.Methods Fifty-two cases of acute exacerbation of type Ⅱ respiratory failure treated in our hospital from February 2014 to February 2016 were selected as the research subjects and divided into the observation group and control group according to the random number table method,26 cases in each group.The patients in the two groups were given the treatment of conventional anti-infection,relieving asthma,expectorant,oxygen therapy,bronchodilator,respiratory stimulants,glucocorticoid,etc.The control group used the BiPAP ventilator for 4h,while the observation group used the BiPAP ventilator for 8h.The changes of blood gas indicators,respiratory rate（RR）,heart rate（HR）and mean arterial pressure（MAP）were observed before and after treatment.The changes of sleep quality indexes and occurrence of adverse reactions after 7dtreatment were compared between the two groups.Results Compared with the control group,the levels of PaO2,SpO2 and pH after treatment in the observation group were significantly increased,while the levels of PaCO2,RR,HR and MAP in the observation group were significantly decreased（P〈0.05）;the sleep quality after 7dtreatment in the observation group was significantly better than that in the control group（P〉0.05）;the adverse reactions of gastric distension,skin lesions and ear discomfort occurred during treatment course had no statistical difference between the two groups（P〈0.05）.Conclusion Extending the ventilation time of BiPAP ventilator can effectively improve the blood gas indicators and respiratory function in the patients with typeⅡ respiratory failure and is worthy of clinic promotion.