经鼻面罩双水平气道正压通气联合呼吸兴奋剂治疗肺性脑病60例疗效观察  

The Effect of BiPAP ventilation combined with respiratory stimulant in 60 patients with pulmona ry encephalopath

作　　者：袁文胜[1] 张念[1] 孙洁民[1] 

机构地区：[1]武汉市第一医院呼吸科,430022

出　　处：《临床内科杂志》2011年第3期181-183,共3页Journal of Clinical Internal Medicine

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、肺性脑病早期的应用价值。方法将60例COPD并发Ⅱ型呼吸衰竭、肺性脑病的患者在抗感染、解痉平喘、抗炎、止咳、化痰等常规治疗基础上随机分为BiPAP治疗组（简称BiPAP组）和BiPAP联合呼吸兴奋剂治疗组（简称联合组），联合组于BiPAP组基础上给予呼吸兴奋剂治疗，观察两组治疗前、治疗后4小时、治疗结束后血气分析、血氧饱和度和心率改善程度的变化。结果两组患者治疗后血气分析结果均明显改善（P〈0．05），联合组的治疗成功率、避免行有创机械通气等方面，与BiPAP组比较差异有显著性（P〈0．05）。结论联合组治疗肺性脑病时，其改善症状和动脉血气指标疗效显著，联合组的治疗有效率、避免行有创机械通气等方面均优于BiPAP组。Objective To investigate the effect of BiPAP ventilation combined with respiratory stimulant in 60 patients with pulmonary encephalopath. Methods 60 AECOPD patients with pulmonary eneephalopathy were randomly divided into two groups：the BiBaP therapy group and B/PaP eombined with respiratory stimulant therapy group. The two groups were both based on conventional therapy group such as antibiotic, paeifying gasp, eliminating phlegm, etc. Arterial blood gas （ pH, PaCO2 , PaO2 , SaO2 and heart rate was oberserved. Result There was a significant improvement of PaO2 （ P 〈 0. 05 ） , pH and heart rate after the therapy,while PaCO2 decreased （ P 〈 0.05 ）. The effeetive rate of the eombined group （ 26/30, 86.6% ） was higher than that of BiPaP group （ 20/30,66.7 % ） （ P 〈 0. 05 ）. Conclusion BiPAP ventilation and BiPAP ventilation combined with respiratory stimulant can relief pulmonary eneephalopathy. The need for IPPV was decreased significantly.

关 键 词：慢性阻塞性肺疾病 肺性脑病 双水平气道正压 呼吸兴奋剂 

分 类 号：R563.8[医药卫生—呼吸系统]