无创正压通气在慢性阻塞性肺疾病呼吸衰竭重症患者中的疗效  

Therapeutic Effects of Noninvasive Positive Pressure Ventilation on Severe Patients with Respiratory Failure Caused by Chronic Obstructive Pulmonary Disease

作　　者：郑天勇[1] 蒋龙元[1] 陈玉成[1] 

机构地区：[1]中山大学附属第二医院急诊科,510120

出　　处：《岭南急诊医学杂志》2009年第1期20-22,共3页Lingnan Journal of Emergency Medicine

摘　　要：目的:探讨无创正压通气(NPPV)治疗慢性阻塞性肺疾病(COPD)呼吸衰竭重症患者的疗效。方法:对入选的30例COPD呼吸衰竭重症(拒绝有创通气,A组)患者和24例具COPD呼吸衰竭无创正压通气适应证患者(B组)在常规治疗的基础上行双水平无创正压辅助通气(BiPAP),观察治疗前后动脉血气、成功率、不良反应及死亡率情况。结果:A组30例患者中20例经BiPAP通气后好转;血气分析指标、成功率、不良反应的发生率与B组治疗后比较,差异无统计学意义(P>0.05),两组治疗后血气指标优于治疗前,差异有统计学意义(P<0.05),但B组死亡率明显高于A组(P<0.05)。结论:无创正压通气治疗COPD呼吸衰竭的应用范围可在非适应证者中适当扩大。Objective:To analyze the effects of noninvasive positive pressure ventilation(NPPV)on severe cases with respiratory failure caused by chronic obstructive pulmonary disease(COPD).Methods:30 patients(Group A) with severe COPD rejecting invasive ventilation(NPPV) treatment and 24 cases(Group B) who had indication to noninvasive positive pressure ventilation were treated by bi-level positive air way pressure(BiPAP) ventilation on base of routine therapy.Arterial blood gas(ABG),success ratio,adverse reaction and death rate were investigate on pretreatment and post-treatment.Results:20 patients in Group A were improved after treatment.The parameters of ABG,success ratio,adverse reaction were not statistically significant after treatment in the two groups(P>0.05). But To the parameters of ABG in the two groups were better in post-treatment than that in pretreatment(P<0.05). The death ratio was higher in Group A than that in Group B(P<0.05).Conclusion:Application scope of NPPV can enlarge in the patients who have not indication with respiratory failure caused by chronic obstructive pulmonary disease.

关 键 词：慢性阻塞性肺疾病 呼吸衰竭 重症 无创正压通气 

分 类 号：R563.9[医药卫生—呼吸系统]