双水平气道正压通气(BIPAP)呼吸机治疗COPD并Ⅱ型呼吸衰竭患者的疗效评估

Effects of BIPAP Breathing on the Treatment of COPD and Type Ⅱ Respiratory Failure

目的:探讨双水平气道正压通气治疗慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭的临床疗效。方法:选取我院收治的COPD合并Ⅱ型呼吸衰竭患者84例,随机分为对照组和研究组,每组42例。对照组患者给予常规治疗,研究组患者在常规治疗基础上给予双水平气道正压通气治疗。观察并记录两组患者治疗前后动脉血气分析、肺功能变化以及临床疗效。结果:研究组治疗有效率高于对照组,差异具有统计学意义(P<0.05);与治疗前比较,两组患者治疗后PaO_2、SaO_2、pH均升高,而PaCO_2均降低,差异具有统计学意义(P<0.05);与对照组比较,研究组治疗后PaO_2、SaO_2、pH水平较高,PaCO_2水平较低,差异具有统计学意义(P<0.05);与治疗前比较,两组患者治疗后FEV1、FVC、FEV1%pre和FEV1/FVC均升高,差异具有统计学意义(P<0.05);与对照组比较,研究组治疗后FEV1、FVC、FEV1%pre和FEV1/FVC较高,差异具有统计学意义(P<0.05);研究组住院时间、气管插管率均低于对照组,差异具有统计学意义(P<0.05)。结论:双水平气道正压通气(BIPAP)呼吸机治疗COPD并Ⅱ型呼吸衰竭患者疗效确切,能显著改善肺功能及动脉血气指标,值得推广。

Objective： To investigate the effects of BIPAP breathing on the treatment of COPD and type II respiratory failure. Methods： 84 patients with COPD and type II respiratory failure who were treated in our hospital were selected, and randomly divided into the experiment group and the control group, with 42 cases in each group. The patients in the control group were treated with the conventional method, while the patients in the experiment group were treated with BIPAP breathing on the basis of the conventional method. Then the arterial blood gas analysis, the pulmonary function and the clinical effects in the two groups were observed and compared before and after the treatment. Results： The effective rate of the experiment group was higher than that of the control group, and the difference was statistically significant （P〈0.05）; Compared with before treatment, the levels of PaO2, SaO2 and pH in the two groups increased after the treatment, while the levels of PaCO2 decreased, and the differences were statistically significant （P〈0.05）; Compared with the control group, the levels of PaO2, SaO2 and pH in the experiment group were higher after the treatment, while the level of PaCO2 was lower, and the differences were statistically significant （P〈0.05）; Compared with before treatment, the levels of FEV1, FVC, FEV1% pre and FEV1 / FVC in the two groups increased after the treatment, and the differences were statistically significant （P〈0. 05）; Compared with the control group, the levels ofFEV1, FVC, FEV1 % pre and FEV1 / FVC in the experiment group were higher after the treatment, and the differences were statistically significant （P〈0.05）; The hospitalization and tracheal intubation rate of the experiment group were lower than those of the control group, and the differences were statistically significant （P〈0.05）. Conclusion： BIPAP breathing has better effects in the treatment of COPD and type II respiratory failure, which can significantly improve the lung function and arterial blood gas indexes.