无创呼吸机在治疗老年AECOPD合并呼吸衰竭中的临床价值  

Noninvasive ventilator in the old AECOPD combination of respiratory failure the clinical value

作　　者：林涛[1] 邓治平[1] 杨莹[1] 

机构地区：[1]自贡市第一人民医院呼吸内科,四川自贡643000

出　　处：《四川医学》2013年第2期248-250,共3页Sichuan Medical Journal

摘　　要：目的探讨无创呼吸机在治疗老年慢性阻塞性肺疾病急性加重期(AECOPD)合并呼吸衰竭中的疗效及临床价值,为临床治疗AECOPD提供参考。方法对我院2010年1月～2012年8月期间住院治疗的48例AECOPD合并呼吸衰竭在常规治疗基础上采用无创正压通气(NPPV)治疗,观察治疗前后患者氧分压(PaO2)、二氧化碳分压(PaCO2)、pH、心率(HR)、呼吸频率(R)变化,患者呼吸暂停低通气指数(AHI)、微觉醒时间(MAI)、血氧饱和度低于90%时间所占总睡眠时间百分比(Ts90%),患者改为有创通气人次及病死情况。结果 48例患者中有4例因为病情加重在无创正压通气中途改为有创通气,死亡1例,病死率2.09%,44例患者NPPV治疗,最终治愈出院,治疗有效率91.67%;NPPV治疗患者在采用无创呼吸机上机治疗后24h、72h时监测的HR、R、pH、PaO2、PaCO2均较治疗前明显改善,与治疗前比较差异有统计学意义(P<0.05),有7例出现睡眠呼吸暂停低通气综合征(SAHS),发生率为15.91%,MAI、AHI、Ts90%在治疗后24h、72h较治疗前明显改善,与治疗前比较差异有统计学意义(P<0.05)。结论 AECOPD合并呼吸衰竭患者采用无创呼吸机正压通气治疗能明显改善患者通气、换气功能及睡眠呼吸障碍,疗效肯定。Objective To investigate noninvasive ventilator in the old of senile chronic obstructive pulmonary disease acute exacerbation（AECOPD） combination of respiratory failure the effect and clinical value,provide the reference for clinical treatment AECOPD.Methods The clinical data from January 2010-August 2012 hospitalized during the 48 cases AECOPD combination of respiratory failure in the conventional treatment on the basis of noninvasive positive pressure ventilation（NPPV） treatment,observed before and after treatment with oxygen partial pressure（PaO2）,carbon dioxide partial pressure（PaCO2）,PH value,heart rate（HR）,respiratory frequency（R） change,patients apnea low ventilation index（AHI）,micro awakening time（MAI）,blood oxygen saturation is lower than 90% of the time have to total sleep time percentage（Ts90%）,patients to have and air passengers and ill situation.Results 48 cases were 4 cases because of illness in the noninvasive positive pressure ventilation midway to have and ventilation,1 case death,and mortality was 2.09%,44 patients NPPV treatment,finally cured and discharged, treatment effectiveness 91.67%;NPPV treatment used in patients with non-invasive breath machine machine treatment within 24h,72h monitoring of the HR,R,pH,PaO2,PaCO2 than before treatment significantly improved,and before treatment comparative differences exist statistical significance（P〈0.05）,there are 7 cases with sleep apnea syndromes（SAHS）,a rate of 15.91%,MAI,AHI,Ts90 % in the treatment of within 24h,72h a before treatment significantly improved,and before treatment comparative differences exist statistical significance（P〈0.05）.Conclusion AECOPD combination of respiratory failure were treated by noninvasive ventilator positive pressure ventilation treatment can significantly improve patients with ventilation,ventilation function and a sleep-related breathing disorder,curative effect affirmation.

关 键 词：慢性阻塞性肺疾病急性加重期 呼吸衰竭 无创正压通气 

分 类 号：R563.9[医药卫生—呼吸系统]