间断无创通气和深呼吸法治疗老年慢性呼吸衰竭临床分析

Clinical discontinuous non-invasive mechanical ventilation and deep breathing in COPD induced chronic hypercapnic respiratory failure

目的 探讨减少慢性呼吸衰竭急性发作提高生活质量的治疗方法。方法 对9例慢性呼吸衰竭老年患者分别进行了间断无创通气和深呼吸两种方法的疗效观察,5例PaCO_2 60～70mmHg者间断无创通气治疗,1.5h/次,2～3次/d。4例PaCO_2 50～60mmHg者接受间断深呼吸和呼吸方式训练。结果 两组治疗后血气指标达到或接近正常。一般状况均明显改善,活动能力明显增加,“上感”次数明显减少。无创通气组平均住院日仅为治疗前的18.64％,平均住院费为治疗前的12.72％。结论 间断无创通气和深呼吸法均为较好的提高慢性阻塞性肺疾病(COPD)慢性呼吸衰竭患者的生活质量、降低住院时间和住院费用的有用方法。

Objective To probe the method of decreasing acute exacerbations of chronic respiratory failure and improving quality oflife for patients with chronic hypercapnic respiraory failure and hypoxemia. Methods 9 patients (aged 70. 2 ± 6. 5, range: 60～76) withcronic hypercapnic respiratory failure and hypoxemia have been studied. Five of them with 60～70mmHg PaCO_2 were treated with discontinu-ous non-invasive positive pressure ventilation (DNIHV), 1. 5 houre per time, 2～3 times per day. The rest with 50～60mmHg PaCO_2 weretreated with method of discontinuous deep breath(degree: 10～20 breaths per time, 3～5 times per day). Results By the time of the study,all patients' indexes of arterial blood gas assays (pH、PaO_2、PaCO_2) were improved. The general conditions of them showed a distinct improve-ment. The exercise patience were increased when compared to values before treatment. The times of their suffering common cold were de-creased distinctly. Average hospitaliztion rates were decreased significantly after initiating DNIHV (117 days vs 9. 3 days for one year). Aver-age cost of hospitalization was decreased significantly(536423. 96 YUAN vs 6823. 41 YUAN RMB for one year). Conclusions DNIHV anddiscontinuous deep breathing are preferable methods to immprove quality of life for patients with chronic hypercapnic respiratory failure and hy-poxemia, to decrease hospitalization rates and to decrease cost of hospitalization.