无创双水平气道正压通气治疗慢性阻塞性肺疾病呼吸衰竭的临床观察  

Clinical Observation on Treatment of Chronic Obstructive Pulmonary Disease with Respiratory Failure by Using Harmless Bilevel Positive Airway Pressures

作　　者：饶怀庐[1] 历风元[1] 李云华[1] 张儒莲[1] 彭朝华[1] 

机构地区：[1]南昌市第一医院呼吸内科,江西南昌330008

出　　处：《江西医学院学报》2006年第1期73-74,77,共3页Acta Academiae Medicinae Jiangxi

摘　　要：目的评估无创双水平气道正压通气(BiPAP)治疗慢性阻塞性肺疾病(COPD)呼吸衰竭的作用。方法将142例确诊为COPD呼吸衰竭患者随机分为两组,对照组72例,采用常规治疗;治疗组70例,在常规治疗的基础上给予BiPAP呼吸机经面罩气道正压通气,观察临床表现,动脉血气变化。结果治疗组BiPAP通气4 h后,64.2%患者呼吸困难明显改善,RR由(35±4)次/min降至(25±6)次/min(P<0.05),明显优于对照组。BiPAP通气4 h后改用鼻导管给氧(2 L/min),30 min后查气分析。PaO2由治疗前(53±6)mmHg升至(76±12)mmHg(P<0.05)明显优于对照组。至治疗结束时,对照组存活率75%,治疗组存活率85.8%(P<0.05)。插管率从对照组51.3%降至27.1%(P<0.05)死亡率从对照组25%降至14.2%(P<0.05)。结论无创双水平气道正压通气对COPD呼吸衰竭患者的疗效肯定,是一种有效、简便、无创而实用的治疗方法。Objective To study the effect of noninvasive Bi-level Positive Airway Passage （BiPAP） on Chronic Obstructive Pulmonary Disease（COPD） with respiratory failure. Methods One hundred and forty two patients who were identified COPD with respiratory failure were divided into two groups randomly： 72 in control group using conventional method while 70 in treatment group in which BiPAP was used in addition of conventional treatment and change arteria blood gas and clinical performance were observed. Results Through four-hour＇s BiPAP ventilation,64.2% of dyspnea patients in the treatment group were better obviously. The frequency of breathing decreased from（35±4）times/min to（25±6）times/min（P〈0. 05） ,which was much better than that in the control group. After four-hours of BiPAP ventilation, use nasal catheter oxygen inhalation and examine blood gas analysis, paO2 rose from （53± 6） mmHg to （76± 12） mmHg （P 〈 0.05） which was far better than that in the control group. Till the treatment was finished, total effective rates of the control group and treatment group were 75% and 85.8%, respectively（P〈0.05） while intubation rate fell from 51.3% in the control group to 27.1%（P〈0.05）in the treatment group and death rate felt from 25 % to 14.2 % （P〈0.05）. Conclusion Compared with conventional treatment, harmless bi-level positive air pressure is useful in dealing with COPD with respiratory failure and is an effective, simple,harmless and practical treating method.

关 键 词：双水平气道正压通气 慢性阻塞性肺疾病 呼吸衰竭 

分 类 号：R563.8[医药卫生—呼吸系统]