无创通气治疗慢性阻塞性肺疾病急性发作合并呼吸衰竭的疗效观察  

Therapeutic effect observation of non-invasive positive pressure ventilation on acute exacerbation of chronic obstructive pulmonary disease accompanied with respiratory failure

作　　者：尚愚[1] 肖金玲[2] 吕福祯[2] 邵玉霞[2] 陈宏[2] 

机构地区：[1]哈尔滨市第一医院呼吸科,黑龙江哈尔滨150006 [2]哈尔滨医科大学附属第二医院呼吸科,黑龙江哈尔滨150081

出　　处：《哈尔滨医科大学学报》2012年第2期157-159,162,共4页Journal of Harbin Medical University

基　　金：黑龙江省科技攻关项目(GC06C415)

摘　　要：目的研究无创机械通气对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)合并Ⅱ型呼吸衰竭的疗效。方法将207例慢性阻塞性肺病合并Ⅱ型呼吸衰竭患者随机分为治疗组(n=104例)和对照组(n=103例)。治疗组与对照组均给予抗感染、舒张支气管、止咳化痰、氧疗,治疗组在此基础上给予无创机械通气辅助治疗。观察治疗前后患者呼吸困难缓解程度和治疗后4 h、48 h的动脉血气分析、平均住院时间及住院病死率。结果治疗组给予无创通气后,动脉血气PaO2明显上升(P<0.05),PaO2下降明显(P<0.05)。结论双水平无创正压机械通气对慢性阻塞性肺病合并Ⅱ型呼吸衰竭的治疗效果好,缓解速度快,有效,明显缩短患者平均住院时间及降低住院病死率。Objective To study the clinical efficacy of non-invasive mechanical ventilation in the treatment of chronic obstructive pulmonary disease（COPD） patients with type Ⅱ respiratory failure.Methods Two hundred and seven patients with COPD with type Ⅱ respiratory failure were divided into the treatment group（104 cases） and control group（103 cases）.Anti-infection,eliminating phlegm,relieving asthma and oxygen therapy were given to both groups and the treatment group was treated with bi-level positive airway pressure（BiPAP） ventilation in addition to above routine treatment.Dyspnea relieving degree,the artery blood gas were obtained at the 4 h,48 h.Average length of stay and hospital mortality were observed before and after the treatment.Results PaO2 and PaCO2 changed more significantly in treatment group than that in the control group（P0.05）.Conclusion BiPAP is definitely valuable for treatment of COPD patients with type Ⅱ respiratory failure and can shorten the mean hospital time and reduce hospital mortality.

关 键 词：无创机械通气 慢性阻塞性肺疾病 呼吸衰竭 

分 类 号：R730.5[医药卫生—肿瘤]