无创正压机械通气在特发性肺纤维化呼吸衰竭治疗中的应用

The application of non-invasive positive-pressure ventilation (NIPPV) on the res by idiopathic pulmonary fibrosis (IPF)

目的 :探讨无创机械通气治疗特发性肺纤维化 (IPF)所致呼吸衰竭的作用及效果。方法 :回顾经口鼻面罩正压机械通气 (NIPPV)治疗IPF所致呼吸衰竭 2 5例病例 ,分析比较治疗前后的临床症状、生活质量、动脉血气分析的变化 ,以及治疗中的副反应。结果 :2 5例病例有 2 1例的临床症状和动脉血氧分压明显好转改善 ,NIPPV治疗 2hPaO2 和SaO2 明显上升 ,PaCO2 明显回升 (P <0 .0 0 1、0 .0 0 1、0 .0 13) ,经NIPPV治疗的临床症状缓解率达 84 %。 11例生活质量改善。口咽干燥和胃胀气为主要副反应。结论 :尽管目前IPF的临床治疗尚缺乏有效的方法 ,但NIPPV治疗可以缓解IPF所致的低氧血症 ,提高患者生活质量 ,延长患者生命 ,并具有副反应少、临床应用方便等优点 。

Objective: To investigate the effects of NIPPV on respiratory failure caused by IPF. Methods: Twenty-five cases were reviewed and analyzed, in which 25 patients were studied regarding the effects of NIPPV on respiratory failure caused by IPF. Study and comparison were done with respect to the clinical symptoms, quality of life, alteration of arterial blood gas analysis and adverse effects. Results: Out of 25 patients clinical symptoms and blood gases were significantly improved in 21 patients, PaO 2, SaO 2 were enhanced and PaCO 2 regression after NIPPV 2 hours. (P<0.001?0.001?0.013). The remission rate of NIPPV was 84%. The quality of life was improved in 11 patients. The bloating and the dehydration of oropharynx were main side effect. Conclusion: The NIPPV is effective in aspects of improve of hypoxia, quality of life, lengthening of survival time and the technique has less side effects and is convenient for application although there is no means and techniques for cure of the disease.