无创通气治疗慢性阻塞性肺疾病并发Ⅱ型呼吸衰竭的临床研究  

Evaluation of non-invasive ventilation in the treatment of chronic obstructive pulmonary disease complicated with type Ⅱ respiratory failure

作　　者：黄志华[1] 林晓[1] 金咏絮[1] 王碧瑛[1] 

机构地区：[1]福建医科大学附属第一医院呼吸科,福州350004

出　　处：《中国综合临床》2008年第6期545-547,共3页Clinical Medicine of China

基　　金：福建省教育厅科研项目（JB03187）

摘　　要：目的探讨应用无创双水平正压通气（BiPAP）呼吸机治疗慢性阻塞性肺疾病（COPD）并发Ⅱ型呼吸衰竭的临床应用价值。方法将56例COPD急性加重并发Ⅱ型呼吸衰竭患者随机分为观察纽和对照组，观察组应用BiPAP＋常规综合治疗，对照组常规综合治疗。观察2组治疗后血气分析结果、呼吸频率、心率、辅助呼吸肌动用评分、气管插管率、病死率。结果观察组治疗后PO2明显升高，PCO2明显降低，pH明显改善，呼吸频率、心率、辅助呼吸肌动用评分下降；对照组各指标无改善。观察组气管插管率、住院病死率与对照组相比显著降低，差异均有统计学意义（均P〈0、05）。结论对COPD并发Ⅱ型呼吸衰竭患者，在常规药物治疗的基础上，给予BiPAP呼吸机辅助通气治疗可以提高疗效，缓解呼吸肌疲劳，降低气管插管率及病死率。Objective To investigate the clinical significance of BiPAP mechanical ventilation in the treatment of chronic obstructive pulmonary disease （ COPD ） with type Ⅱ respiratory failure. Methods A total 56 patients suffering from respiratory failure due to exacerbation of COPD were randomly divided into treatment group （ BiPAP plus routine therapy ） and control group （ routine comprehensive therapy）. Blood gases, respiratory rates, heart rates, scores of the activity of accessory respiratory muscles ,incubation rate, fatality rate were observed. Results In the treatment group, PO2 greatly increased, PCO2 greatly decreased, pH improved significantly, and respiratory rate, heart rate and scores of the activity of accessory respiratory muscles greatly decreased. The incubation rate and the fatality rate were significantly lower in the treatment group than those in the control group （ P 〈 0.05 ）. Conclusion BiPAP mechanical ventilation plus routine therapy on COPD with type Ⅱ respiratory failure can improve the curative effects, lessen respiratory muscle fatigue ,and decrease the need for incubation and fatality rate.

关 键 词：慢性阻塞性肺疾病 呼吸衰竭 无创通气 

分 类 号：R563.9[医药卫生—呼吸系统]