无刨呼吸机治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭临床疗效观察

Clinical observation of non-invasive ventilation in the treatment of COPD with type Ⅱ respiratory failure

目的:探讨无创呼吸机治疗慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭的疗效。方法:选取60例COPD合并Ⅱ型呼吸衰竭患者,随机分为对照组与治疗组。予对照组抗感染、吸氧、解痉平喘、祛痰、纠正酸碱失衡、电解质紊乱及改善心功能等治疗。治疗组在对照组的基础上加用无创正压通气,观察治疗前后患者临床表现、血气分析的变化结果两组临床疗效比较,治疗组总有效率为86.7%,对照组为60.0%,两组比较差异有统计学意义(P<0.05)两组治疗前后动脉血气分析变化,治疗组动脉血氧分压(PaO_2)血氧饱和度(S_PO_2)显著高于对照组(P<0.05),二氧化碳分压(PaCO_2)显著低于对照组(P<0.05).结论:无创呼吸机治疗COPD合并Ⅱ型呼吸衰竭可明显提高PaO_2,降低PaCO_2,改善血流动力学,减轻肺水肿,可降低病死率。

Objective:To study the efficacy and safety of non-invasive ventilation in chronic obstructive pulmonary disease(COPD) with type Ⅱ respiratory failure.Methods 60 patients with COPD complicated with type Ⅱ respiratory failure were randomly divided to receive conventional therapy(conventional therapy group) or NIPPV with the conventional therapy(BiPAP group).After the therapy,the blood gases,heart rate,and blood pressure were observed.Results Compared with the conventional therapy group,there was a significant improvement of PaO_2,SpO_2(P<0.05) and there was an obvious decrease in Pa0O_2(P<0.05) in BiPAP group.The therapy effective rate of BiPAP group was obvious higher than that of conventional therapy group(P< 0.05).Conclusion The non-invasive ventilator adjuvant treatment of respiratory failure COPD with type II absolute efficacy.