双水平气道正压通气治疗慢性阻塞性肺疾病合并急性呼吸衰竭的临床研究  

Bi-level positive airway pressure ventilation in chronic obstructive pulmonary disease with acute respiratory failure

作　　者：吴峰[1] 谢汉华[1] 魏启宏[1] 杨德春[1] 丁惠珍[1] 顾学仁[1] 

机构地区：[1]江苏省扬州市第一人民医院扬州大学第二临床医学院,扬州225001

出　　处：《国外医学（呼吸系统分册）》2005年第12期888-890,共3页Section of Respiratory System Foreign Medical Sciences

摘　　要：目的探讨经鼻面罩双水平气道正压(BiPAP)通气在慢性阻塞性肺疾病(COPD)合并急性呼吸衰竭早期的应用价值。方法将80例COPD合并急性呼衰患者分为2组,每组40例,在进行抗感染、对症等常规治疗的同时,分别给予持续静滴可拉明及经鼻面罩BiPAP通气治疗6小时,判断两组之间治疗前后生命体症及血气分析变化。结果两组治疗6小时后,机械通气组在血压、心率、呼吸频率方面改善均显著优于对照组(P<0.01);对照组pH值无改善,而机械通气组pH值显著改善,与对照组相比有显著差异(P<0.01);机械通气组和对照组治疗后均有PaO2上升和PaCO2下降,但机械通气组改善更明显,与对照组相比有显著差异(P<0.01)。结论经鼻面罩BiPAP通气适合治疗COPD合并急性呼衰患者,其在改善临床症状和动脉血气指标方面均优于常规治疗,值得临床推广。Objective To determine the efficacy of Nasal mask Bi-level positive airway pressure （BiPAP） ventilation in early-staged chronic obstructive pulmonary disease （COPD） with acute respiratory failure. Methods 80 cases of early-staged COPD accompanied by acute respiratory failure were divided into two groups： coramine was added to conventional management in 40casese of control, and 6 hours of nasal mask Bi-PAP ventilation was added to conventional management in 40 cases of Bi-PAP group. Vital Signs and blood gas analysis were evaluated. Results After 6 hours of treatment, blood pressure,heart rate and respiratory frequency were significantly improved in Bi-PAP group than coutrol. Compared with control, there was a significant improvement in pH in Bi-PAP group （ P〈0.01）. Increase in PaO2 and decrease in PaCO2 were found in both groups,amplitudes of PaO2 and PaCO2 before and after treatment were greater in Bi-PAP group of （MV） than control （ P 〈 0.01）. Conclusions Nasal mask Bi-PAP ventilation in earlystaged COPD accompanied with acute respiratory failure improves gas exchange and symptoms more significantly than conventional management.

关 键 词：慢性阻塞性肺疾病 呼吸衰竭 双水平气道正压 

分 类 号：R563.9[医药卫生—呼吸系统] R563.8[医药卫生—内科学]