无创机械通气在治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭中的应用及临床分析  

The application of noninvasive bilevel continuous airway pressure ventilation on chronic obstructive pulmonary desease complicated by type Ⅱ respiratory failure and its clinical analysis

作　　者：贾东岩 王志刚[1] 李亚光[1] 侯海军 安鹏 

机构地区：[1]通州区中医医院呼吸科,北京101100

出　　处：《临床和实验医学杂志》2009年第10期31-33,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的观察无创机械通气(BiPAP)在治疗慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭中的应用及临床疗效。方法选取2004年10月到2008年12月COPD患者合并Ⅱ型呼吸衰竭患者46例,随机分为两组,每组23例,对照组采用常规治疗,治疗组在常规治疗基础上采用BiPAP治疗。两组对比。结果对照组治疗3h后动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)较治疗前明显改善,差异有显著性(P<0.05);而呼吸、心率及pH与治疗前比较,无统计学意义(P>0.05)。治疗组治疗3h后呼吸、心率及PaCO2均较治疗前明显下降,PaO2、pH明显升高,差异具有显著性(P<0.05)。并且,治疗3h后治疗组呼吸、心率、PaO2、PaCO2及pH改善情况均较对照组明显,差异有显著性(P<0.05)。治疗组有效率明显高于对照组,差异具有显著性(P<0.05)。治疗组病死率低于对照组,但无统计学意义(P>0.05)。治疗组的住院时间明显短于对照组,差异均有显著性(P<0.05)。结论BiPAP具有无创、并发症少的特点,能减少患者的痛苦,节省治疗费用,是治疗COPD合并Ⅱ型呼吸衰竭的一项行之有效、安全可靠的治疗措施。Objective To observe the application of noninvasive bilevel continuous airway pressure （BiPAP） ventilation on chronic obstructive pulmonary disease （COPD） complicated by type Ⅱ respiratory failure and its clinical analysis. Methods From October 2004 to December 2008, 46 cases with COPD complicated by type Ⅱ respiratory failure were randomly classified into two groups with 23 cases in each group. Patients in control group were treated with routine therapy, while patients in treatment group were treated with BiPAP in addition to routine therapy. Treatment effects were compared between the two groups. Results Compared with pretreatment, PaO2 and PaCO2 in control group were significandy improved 3 h after treatment （ P 〈 0.05 ）, while there were no significant differences in respiration, heart rate and pH （ P 〉 0.05 ）. Compared with pretreatment, respiration, heart rate and PaCO2 were significantly decreased and PaO2 and pH were significantly increased in treatment group 3h after treatment （ P 〈0.05 ）. Moreover, respiration, heart rate, PaO2 , PaCO2 and pH in treatment group were significandy improved than those in control group 3h after treatment （ P 〈 0.05 ）. Compared with control group, the effective rate was higher （ P 〈 0.05 ） and the hospitalized time was shorter （ P 〈 0.05 ） in treatment group, however, there was no significant difference in case - fatality rate between the two groups （ P 〉 0.05）. Conclusion BiPAP ventilation is noninvasive and cheap. It is also an effective and safe method for the treatment of COPD complicated by type Ⅱ respiratory failure.

关 键 词：无创机械通气(BiPAP) 慢性阻塞性肺疾病(COPD) Ⅱ型呼吸衰竭 

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