BiPAP呼吸机无创机械通气治疗COPD合并Ⅱ型呼吸衰竭的探讨

An Approach to the Treatment of Noninvasive Bilevel Positive Airway Pressure(BiPAP) Ventilation in COPD Patients with Type-Ⅱ Respiratory Failure(RF)

目的 探讨双水平气道正压无创通气 (BiPAP)对慢性阻塞性肺疾病 (COPD)合并Ⅱ型呼吸衰竭的治疗价值。方法 在 2 2例COPD合并Ⅱ型呼吸衰竭患者中随机选择 11例 ,进行规律性无创双水平气道正压机械通气辅助治疗 ,每日上机两次 ,每次 2h ,7天为一疗程 ,比较上机前 ,上机后 2h ,2 4h ,7天后动脉血气中PH值 ,PaO2 值 ,PaCO2 值及临床症状变化情况。结果 治疗组治疗后 2h ,2 4h ,7天动脉血气中PH值和PaO2 值逐渐上升 ,PaCO2 值下降 ,临床症状明显改善 ,有效率达 81.81% ,对照组动脉血气中PH值 ,PaO2 ,PaCO2 值及临床表现虽有不同程度的改善 ,但与治疗组同期比较 ,差异均有显著性 (P <0 .0 5 )。

Objective:To examine effects of noninvasive bilevel positive airway pressure (BiPAP) Ventilation in COPD patients with type-Ⅱ respiratory failure(RF).Methods:Twenty-two COPD patients with type-Ⅱ respiratory failure were divided equally at random into two groups:(1) mechanical ventilation and (2) no mechanical ventilation (as control).The first group was treated with double channel noninvasive mechanical ventilator twice a day and 2 hours per time,each course lasted for seven days.Arterial blood PH,PaO 2 and PaCO 2 were measured and changes of clinical symptoms were recorded in both groups before and afte treatment 2 hours,24 hours,seven dyas,respectively.Results:In first group,arterial PH and PaO 2 elevated gradually,accompanying with gradual decline of PaCO 2 and prominently improved clinical symptoms Its effective rate of treat ment was 81.81%.As for the control group,three parameters of arterial blood and clinical symptoms were also improved to a certain degree but significant difference existed as compared with the first group (P<0.05).Conclusion:Noninvasive mechanical ventilation as auxiliarg greatment is definitely Valuable for COPD with respiratory failure patients.