BiPAP呼吸机治疗慢性阻塞性肺疾病合并呼吸衰竭的临床观察  

Study on acute exacerbation of chronic respiratory failure in COPT) treated by BiPAP

作　　者：刘颖祺[1] 朴峻 王悦[1] 张丽艳[1] 刘郁飞[1] 

机构地区：[1]沈阳市第五人民医院呼吸科,辽宁沈阳110023

出　　处：《中国呼吸与危重监护杂志》2002年第4期236-237,共2页Chinese Journal of Respiratory and Critical Care Medicine

摘　　要：目的 探讨经鼻(面)罩双水平气道内正压通气(BiPAP)治疗慢性阻塞性肺疾病(COPD)合并呼吸衰竭急性加重期的可行性。方法 对COPD慢性呼吸衰竭急性加重患者23例行BiPAP治疗。以同期同等病情程度患者21例做对照。试验组正压通气每日1～2次,每次2h,共7d。通气时注意气道通畅和同步性。结果 试验组治疗1周后,呼吸困难明显减轻,辅助呼吸肌参与呼吸的程度减少或消失,潮气量提高(P<0.01),呼吸频率及心率减慢(P<0.01),血压无明显变化。PaO_2上升、PaCO_2下降,与治疗前比较均有显著性差异(P<0.01)。pH升高(P<0.05),酸中毒明显缓解。住院天数平均为(15±5)d。对照组药物治疗1周后,状态缓解不明显,pH、PaO_2及PaCO_2与治疗前比较均无显著性差异(P>0.05)。住院天数平均(28±8)d。结论 BiPAP治疗COPD合并呼吸衰竭操作简单,效果较好,并发症少,患者易于接受,值得临床推广。Objective To study the effect of BiPAP on acute exacerbation of chronic respiratory failure in COPD patients.Methds 23 COPD patients with acute exacerbation of chronic respiratory failure were treated with facial/nazal mask BiPAP. Another 21 similar patients treated by conventional therapy were served as control. Mask ventilation was given 2 hours every time and 1 - 2 time daily for 7 days. Synchrony and airway patiency were intensively monitored. Results After one week of mask vetila-tion, patients had lower PaCO2 (P< 0.01), higher PaO2, ( P < 0.01), better tidal volume( P< 0.01), slower breathe frequency and heart beats cpmpared to controls.Conclusion BiPAP is an easily performed, well-compliant artificial ventilation mode which is able to relieve dyspnea quicklier and reduce necessity for intubation.

关 键 词：治疗前 呼吸衰竭 患者 慢性阻塞性肺疾病 住院天数 PAO2 BIPAP呼吸机 PACO2 并发症 COPD 

分 类 号：R563.8[医药卫生—呼吸系统]