无创正压通气治疗慢性阻塞性肺疾病急性加重期并重度二氧化碳潴留效果观察  

Observation of Nasal Intermittent Positive Pressure Ventilation (NIPPV) in Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease ( AECOPD) and Severe CO_2 Retention

作　　者：李艳肖[1] 史金英[1] 袁德琴[2] 梁春花[1] 赵从会[1] 柴书坤[1] 

机构地区：[1]石家庄市中心医院呼吸科,石家庄050011 [2]石家庄市第三医院急救医学科,石家庄050011

出　　处：《临床误诊误治》2013年第3期75-77,共3页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨无创正压通气(NIPPV)治疗慢性阻塞性肺疾病急性加重期(AECOPD)并重度二氧化碳(CO2)潴留的临床效果。方法选择我院2009年3月—2012年3月收治的AECOPD并重度CO2潴留156例,予无创呼吸机辅助呼吸并常规治疗,观察治疗前后呼吸、心率、血氧饱和度(SaO2)、动脉血气分析指标[pH、氧分压(PaO2)、二氧化碳分压(PaCO2)]变化。结果本组NIPPV治疗2 h后SaO2较治疗前显著升高,差异有统计学意义(P<0.05),呼吸及心率有所下降,但差异无统计学意义(P>0.05);治疗24 h后呼吸、心率及SaO2均较治疗前及治疗2 h后明显好转,差异有统计学意义(P<0.05)。治疗2 h、24 h后pH、PaO2及PaCO2均较治疗前明显好转,差异有统计学意义(P<0.05),治疗2 h后与治疗24 h后比较差异均有统计学意义(P<0.05)。本组NIPPV治疗成功率79.49%,气管插管率20.51%,病死率6.41%。结论 NIPPV可显著改善AECOPD并重度CO2潴留患者的缺氧和二氧化碳潴留,且安全有效。Objective To explore clinical effect of nasal intermittent positive pressure ventilation （NIPPV） in treatment of acute exacerbation of chronic obstructive pulmonary disease （AECOPD） and severe CO2 retention. Methods A total of 156 pa- tients with AECOPD and severe CO2 retention during March 2009 and March 2012 in our hospital were treated with NIPPV and con- ventional therapy, and changes of respiratory rate （RR）, heart rate （HR）, saturation of blood oxygen （SaO2 ）, arterial blood gas a- nalysis （pH, PaO2, PaCO2 ） before and after treatment were observed. Results The SaO2 level was significantly ascensus 2 h after treatment than that before treatment （ P 〈 0. 05 ） ; RR and HR tended to descend, but the differences were not statistically significant （P 〉0.05）. RR, HR and SaO2 levels improved obviously 24 h after treatment than that of 2 h and before treatment （P 〈0. 05）. 2 h and 24 h after treatment the pH, PaO2 and PaCO2 levels significantly improved （ P 〈 0.05 ）, and the difference between 2 h and 24 h after treatment was statistically significant （P 〈 0. 05）. The achievement rate by NIPPV was 79.49%, tracheal cannula rate was 20. 51%, and fatality rate was 6.41%. Conclusion NIPPV can obviously improve the anoxia and CO2 retention of patients with AECOPD and severe CO2 retention safely and effectively.

关 键 词：无创正压通气 肺疾病 慢性阻塞性 呼吸功能不全 

分 类 号：R563.9[医药卫生—呼吸系统]