无创呼吸机治疗老年慢性阻塞性肺疾病并发Ⅱ型呼吸衰竭31例  

Clinical observations of noninvasive positive pressure ventilation for acute exacerbations of elder chronic obstructive pulmonary disease complicated with type Ⅱ respiratory failure

作　　者：杨渭临[1] 丁毅[1,2] 郑华东[1] 陈尔秀[1,2] 孙师元[1] 

机构地区：[1]西安交通大学医学院第二附属医院老年病科,西安710004 [2]西安交通大学医学院第二附属医院急诊科

出　　处：《陕西医学杂志》2012年第1期32-34,共3页Shaanxi Medical Journal

摘　　要：目的:探讨无创正压通气(NIPPV)对老年慢性阻塞性肺疾病急性发作(AECOPD)并发Ⅱ型呼吸衰竭的治疗效果。方法:将我院老年病科、急诊科64例AECOPD并发Ⅱ型呼吸衰竭患者随机分为常规对照组33例(常规抗感染、支气管扩张剂、祛痰药、激素、氧疗、纠正酸碱失衡的治疗)和NIPPV治疗组31例(在常规对照组的治疗基础上,采用美国伟康公司经鼻罩双水平气道正压BiPAP VERSION型呼吸机进行辅助通气)。观察两组患者治疗前后pH、PO2、PCO2、BE、心率、呼吸频率的变化,比较住院时间、气管插管率、病死率。结果:治疗2h、24h后,治疗组和对照组pH、PO2、PCO2、BE、心率、呼吸频率比较有显著性差异(P<0.05)。两组在住院时间、气管插管率、病死率方面也有显著性差异(P<0.05)。结论:NIPPV可加速改善AECOPD并发Ⅱ型呼吸衰竭患者的pH、PO2、PCO2、BE、心率、呼吸频率,可明显缩短住院时间,降低气管插管率、病死率。Objective：To review and summarize the therapeutic effect of noninvasive positive pressure ventilation（NIPPV） on treating acute exacerbations of aged chronic obstructive pulmonary disease（AECOPD） complicated with type Ⅱ respiratory failure,and to analyse correlative factors that affect therapeutic effect.Methods：33 of total 64 patients with AECOPD complicated with type Ⅱ respiratory failure,who admitted in Emergency Department or Veteran Ward Branch in the Second Hospital of Xi＇an Jiao Tong University were randomly grouped as the conventional therapeutic group receiving antibiotics,bronchodilators,expectorants,hormones,oxygen therapy,correcting acid-base imbalance in routine way,and the rest 31 as the NIPPV therapeutic group receiving NIPPV plus conventional therapy.Observed the exchange in pH,PO2,PCO2,BE,HR,RR of the patients,and compared hospital stays,intubation rate,mortality.Results：The index in pH,PO2,PCO2,BE,HR,RR accelerate obviously in NIPPV therapeutic group and conventional therapeutic group,and NIPPV therapeutic group performed better than conventional therapeutic group after ventilating 24 hours（P0.05）.NIPPV therapeutic group cut down hospital stays,intubation rate,mortality much more than conventional therapeutic group.Conclusions：NIPPV accelerates the improvement of pH,PO2,PCO2,BE,HR,RR in patients with AECOPD complicated with type Ⅱ respiratory failure,and shortened their hospital stays,intubation rate,mortality.

关 键 词：肺疾病 慢性阻塞性/并发症 呼吸功能不全/治疗 正压呼吸 老年人 @经鼻(面)罩双水平气道正压BiPAP 

分 类 号：R563.3[医药卫生—呼吸系统]