家庭无创机械通气治疗慢性阻塞性肺疾病合并呼吸衰竭稳定期的临床研究  

Clinical study of home noninvasive positive pressure ventilation treatment of respiratory failure due to the chronic obstructive pulmonary disease in the Balanced State

作　　者：吴波[1] 

机构地区：[1]复旦大学附属中山医院青浦分院呼吸内科,上海201700

出　　处：《国际呼吸杂志》2013年第3期185-187,共3页International Journal of Respiration

摘　　要：目的探讨家庭无创机械通气治疗慢性阻塞性肺疾病（chronic obstructive pulmonarydisease，COPD）合并呼吸衰竭稳定期的可行性，观察其肺功能和血气变化。方法选择2008年2月至2011年2月我科30例COPD合并呼吸衰竭住院患者，给予无创机械通气，每目8～12h，在治疗前后和稳定期分别检测血气分析、肺功能，一般4周为1疗程。通气模式：S／TIPAP（14～20cmH2O）EPAP（3～5cmH2O）。其中10例cOPD合并呼吸衰竭的患者好转出院后自购万曼双水平呼吸机ST22型，给予家庭无创机械通气，模式同上。其余患者出院后给予家庭氧气治疗。出院后半年复查血气和肺功能。结果住院期间应用无创机械通气，30例患者血气和肺功能指标均显著改善，两组比较差异无统计学意义（P〉0．05）。出院后半年，无创机械通气组和吸氧组复查肺功能和血气指标差异有统计学意义（P〈O．05），且住院次数分别为0次和15次。结论家庭无创机械通气可改善患者的血气和肺功能，能减少其住院次数，提高生活质量。Objective To investigate the feasibility of applying noninvasive positive pressure ventilation （NPPV） to the treatment of respiratory failure secondary to the chronic obstructive pulmonary disease （COPD） in the balanced state, and pulmonary function and the change of blood gases were observed. Methods Thirty patients suffering from respiratory failure due to COPD underwent NPPV treatment, for 8-12 hours daily, the blood gas analysis and pulmonary function were examined before and after the treatment, at the balanced state, usually 4 weeks as a course. Ventilation mode：S/T IPAP （18- 22 cm H2O）＋ EPAP （3 - 5 cm H20）. Ten patients with the disease bought the Million Manshuang level ventilator type ST22 respiratory instruments after their conditions bettered and left the hospital. They underwent the NPPV at home. The mode was similar to the former. The others out of the hospital underwent the oxygen therapy. The blood gases and pulmonary function were examined in half a year. Results The blood gases cores and pulmonary function cores had been improved greatly after the 30 patients underwent the NPPV treatment, and there was no significant difference between the scores of two teams （ P 〉0.05）. Half a year out of the hospital, researchers examined the scores of the two teams again, it was found that significant differences existed on the pulmonary function scores and blood gas scores （ P 〈0.05）, and further more, the times of being in hospital again are respectively 0 and 15. Conclusions Having undergone the home NPPV treatment for a long time, the patients will improve their blood gas and pulmonary function, reduce the times of being in hospital, and improve the quality of lives.

关 键 词：慢性阻塞性肺疾病 无创机械通气 呼吸衰竭 

分 类 号：R563.9[医药卫生—呼吸系统]