无创通气对呼吸衰竭病人血气指标的影响  

EFFECTS OF NONINVASIVE BI LEVELS POSITIVE AIRWAY PRESSURE(BiPAP) VENTILATION ON COPD PATIENTS WITH ACUTE RESPIRATORY FAILURE

作　　者：程兆忠[1] 于文成[1] 郝兰萍[1] 刘淑红[1] 

机构地区：[1]青岛医学院附属医院呼吸内科

出　　处：《齐鲁医学杂志》1999年第1期23-25,共3页Medical Journal of Qilu

摘　　要：①目的探讨ＢｉＰＡＰ面罩式无创通气在慢性阻塞性肺疾病（ＣＯＰＤ）并急性Ⅱ型呼吸衰竭（呼衰）治疗中的价值。②方法观察２１例ＣＯＰＤ并呼衰病人应用ＢｉＰＡＰ面罩式无创通气治疗２ｄ后，血气（ＰａＯ２，ＰａＣＯ２和ｐＨ值）分析和临床症状改善情况，并与同期病情相似的２１例呼衰进行常规综合治疗病人及２２例进行气管插管机械通气治疗病人的结果作比较。③结果治疗前３组病人的ＰａＯ２，ＰａＣＯ２和ｐＨ值相比较差异无显著性。治疗后ＢｉＰＡＰ组和插管组分别与治疗前比较，３项血气指标改善显著（ｔ＝２．５００～１０．２３１，Ｐ＜０．０５，０．０１），病人症状减轻或缓解；插管组较ＢｉＰＡＰ组血气改善更明显（ｔ＝２．８０２～３．６３０，Ｐ均＜０．０１）；对照组仅低氧血症和紫绀得到改善（ｔ＝５．５６５，Ｐ＜０．００１）。④结论ＢｉＰＡＰ面罩式无创通气可改善ＣＯＰＤ合并Ⅱ型呼衰病人的血气指标及临床症状。Objective To study the effect of noninvasive Bi levels Positive Airway Pressure(BiPAP) ventilation in chronic obstructive pulmonary disease(COPD) patients with type Ⅱ respiratory failure(RF) in acute exacerbation.\ Methods 64 cases of RF patients were divided into three groups: control group( n =21), BiPAP group( n =21) and intubation group( n =22). Clinical observation and arterial blood gas analysis were performed before and after 2 days treatment and the comparison of results were made among groups.\ Results\ There were no significant differences of PaO 2, PaCO 2 and pH among three groups before treatment. After treatment, the blood gas analysis showed that PaO 2, PaCO 2 and pH were greatly improved in BiPAP group and intubation group( t=2.500-10.231, P <0.05,0.001), the improvement was greater in intubation group( t=2.802-3.630, P <0.01,0.001). In the control group, only PaO 2 was increased after treatment( t=5.565, P <0.001).\ Conclusion\ The noninvasive BiPAP ventilation could improve the blood gas indices and clinical feature of COPD patients with acute RF.

关 键 词：呼吸衰竭 无创通气 血气指标 

分 类 号：R563.805[医药卫生—呼吸系统] R459.6[医药卫生—内科学]