双水平气道正压通气联合振动排痰在AECOPD并Ⅱ型呼吸衰竭的应用  

BiPAP plus vibrating sputum-ejection for acute exacerbation of chronic obstructive pulmonary disease with typeⅡrespiratory failure

作　　者：林增锐[1] 黄泽宽[1] 林武强[1] 

机构地区：[1]揭阳市人民医院呼吸内科,522000

出　　处：《国际医药卫生导报》2011年第9期1053-1055,共3页International Medicine and Health Guidance News

摘　　要：目的探讨双水平气道正压通气（BiPAP）结合振动排痰在慢性阻塞性肺疾病急性加重期（AECOPD）并Ⅱ型呼吸衰竭的临床应用价值。方法30例AECOPD患者随机分为对照组和联合组，对照组予双水平气道正压通气辅助呼吸治疗；联合组在对照组治疗基础上联合振动排痰。结果两组患者治疗后的HR、RR、pH、PaO2、PaCO2有明显改善，有统计学意义（P〈0．01）。治疗1天后，联合组有8例患者的PaCO2降至50mmHg以下，对照组无一例；治疗3天后，联合组有10例患者PaCO2降至50mmHg以下，对照组有6例，联合组的例数仍较多，联合组的患者其HR、RR、pH、PaO2、PaCO2的改善显著优于对照组（P〈0．05）。结论双水平气道正压通气结合振动排痰治疗慢性阻塞性肺疾病急性加重期并Ⅱ型呼吸衰竭患者疗效肯定，有临床应用价值。Objective To explore the values of bilevel positive airway pressure ventilation （ BiPAP ）emnbined with vibrating sputum-ejection for acute exacerbation of chronic obstructive pulmonary disease （ AECOPD ） with type Ⅱ respiratory failure. Methods 30 patients were randomly assigned to receive BiPAP alone （ control group ）, or BiPAP plus vibrating sputum-ejection （ combination group ）. Resulta HR, RR, pH, PaO2, and PaCO2 were obviously improved in the two groups after treatment, with statistical significances （ P〈 0.01 ）. PaCO2 decreased below 50 mmHg in 8 patients in the combination group one day after treatment while stayed still in the control group and it dropped below 50 mmHg in l0 patients in the combination group three days afler treatment but stayed unchanged in 6 patients in the control group, the improvement ofHR, RR, pH, PaO2, and PaCO2 in the combination group was obviously superior to that in the control group （ P 〈 0.05 ）. Conclusions Bilevel positive airway pressure ventilation combined with vibrating sputum-ejection is more effective in the treatment of acute exacerbation of ehronie obstructive pulmonary disease with type II respiratory failure and has a value of clinical application.

关 键 词：双水平气道正压通气 振动排痰 慢性阻塞性肺疾病 Ⅱ型呼吸衰竭 

分 类 号：R563.9[医药卫生—呼吸系统]