经鼻面罩双水平气道正压通气治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭疗效观察  

Bi-level Positive Airway Pressure Ventilation in Chronic Obstructive Pulmonary Disease with Tape Ⅱ Respiratory Failure

作　　者：王平[1] 

机构地区：[1]江苏省淮安市涟水县人民医院呼吸科,223400

出　　处：《实用心脑肺血管病杂志》2009年第12期1046-1047,共2页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

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)并发Ⅱ型呼吸衰竭早期的应用价值。方法将66例COPD并发Ⅱ型呼吸衰竭患者随机分为常规治疗组(对照组)和BiPAP治疗组。常规治疗组给予氧疗、药物等常规治疗,BiPAP治疗组给予常规治疗的同时加用BiPAP无创通气治疗4h,24h,72h,判断两组之间治疗前后心率、呼吸频率、PH值、PaCO2、PaO2变化。结果两组治疗4h,24h,72h后,治疗组在心率、呼吸频率、PH值、PaCO2、PaO2方面改善均显著优于对照组(P<0.05);对照组均有所改善,但无统计学差异(P>0.05)。结论经鼻面罩BIPAP通气适合治疗COPD并发Ⅱ型呼吸衰竭患者,其在改善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-lev el positive airway pressure（Bi-PAP）ventilation inearly-staged chronic obstructive pulmonary disease（COPD）with tape respiratory failure.Methods 66 COPD patients with tape Ⅱ respiratory failure were divided into BiPAP group and conventional therapy treatment group,the BiPAP group were treated by conventional therapy at the same time to use BiPAP,the conventional therapy treatment group were only treated by conventional therapy.Heartrate,breath frequency and blood gas analysis were evaluated,after 4 hours,24 hours,72 hours of treatment.Results After treatment,heart rate and breath frequency were significantly improved in the Bi-PAP group than contro1.Compared with control,there was a significant imp rovement in the PH in Bi-PAP group（P〈0.05）.Increase in PaO2 and dec rease in PaCO2 were found in the both groups,amplitudes of PaO2 and PaCO2 before and after treatment were greater in Bi-PAP group than control（P〈0.05）.Conclusion Nasal mask Bi-PAP ventilation in early-staged COPD accompanied with tape Ⅱ respiratory failure improves gas exchange and symptoms more significantly han conventional man-agement.

关 键 词：慢性阻塞性肺疾病 Ⅱ型呼吸衰竭 双水平气道正压 

分 类 号：R563.8[医药卫生—呼吸系统]