无创正压通气治疗慢性阻塞性肺疾病急性发作合并呼吸衰竭的临床观察

Clinic observation of acute respiratory failure associated with COPD treated in NPPV

目的 :观察无创正压通气治疗慢性阻塞性肺疾病 (COPD)急性发作合并呼吸衰竭的临床效果。方法 :32例COPD患者在常规综合治疗的同时 ,选用BiPAP呼吸机行无创正压通气。在机械通气前 ,机械通气后 1h、4h、2 4h和通气结束时作血气分析 ,并观察临床转归。结果 :与治疗前相比 ,无创正压通气后 1h、4h、2 4h和治疗结束时 ,PH值改善 (P <0 .0 5 ) ,PaO2 上升、PaCO2 下降 (P <0 .0 1 )。 30例患者好转出院 ,2例患者因病情加重 ,改用有创通气后死亡 ,抢救成功率 93.8%。结论 :无创正压通气对COPD急性发作合并呼吸衰竭疗效显著 ,避免了气管插管或气管切开 ,减少了呼吸机相关性肺炎 ,具有良好地应用前景。

Objective: To observe the clinic effect of acute respiratory failure associated with chronic obstructive pulmonary disease(COPD) treated with noninvasive positive pressure ventilation (NPPV). Methods: 32 COPD cases taked BiPAP ventilator in NPPV with the normal treated . Taked hemo-gasometric analysis before, after 1h,4h,24h and at end of treating in machanical ventilation and observed clinic result. Results: Compared with before, after 1h,4h,24h and at end of treating in NPPV late. PH value improved(p<0.05) PaO 2 elevated,PaCO 2 decreased (p<0.01),30 cases discharged better. 2 cases died because the general condition was badly with invasive ventilation ,successful rate was 93.8%. Conclusions:NPPV was a significant effect for acute respiratory failure with COPD avoided the tracheal insertion or tracheotomy decreased ventilator associate pneumonia having an inclusive prosperity.