头罩无创正压通气治疗慢性阻塞性肺疾病急性加重期临床疗效分析  

The efficacy of non-invasive positive pressure ventilation for acute exacerbation of chronic obstructive pulmonary disease patients by a helmet

作　　者：郭华[1] 张容[1] 谢明金[1] 

机构地区：[1]遂宁市第一人民医院呼吸科,四川遂宁629000

出　　处：《西部医学》2013年第5期772-774,共3页Medical Journal of West China

摘　　要：目的研究头罩无创正压通气(NIPPV)治疗慢性阻塞性肺疾病急性加重期(AECOPD)患者的临床疗效。方法 86例AECOPD患者按照入院先后顺序随机分成研究组和对照组各43例,两组均在常规治疗的基础上,对照组予口鼻面罩给氧治疗,研究组予头罩无创正压通气治疗,治疗后比较分析两组患者的相关临床资料。结果两组患者治疗前后的RR、HR、PH以及SAP水平均无统计学差异(P>0.05);而治疗后两组患者的PaCO2水平明显降低,PaO2/FiO2显著升高,且均具有统计学差异(P<0.05);两组间的NIPPV治疗时间和住院死亡例数均无统计学差异(P>0.05);而与对照组比较,研究组的压力支持水平显著升高,其漏气发生率、初始24小时治疗中断例数以及初始24小时治疗中断频数明显降低,且均具有统计学差异(P<0.05)。两组患者的无创正压通气相关并发症发生率具有统计学差异(34.88%VS4.65%,P<0.05)。结论头罩NIPPV治疗AECOPD患者具有较好的疗效和耐受性,特别适用于合并有I型呼吸衰竭的AECOPD患者。Objective To analysis the efficacy of non-invasive positive pressure ventilation for acute exacerbation （NIPPV） of chronic obstructive pulmonary disease （AECOPD） patients by a helmet. Methods 86 cases with AECOPD were randomized to divide into 2 groups, the faeemask treatment groups and helmet treatment groups. Results There was no significant improvement in the RR, HR, PH, SAP after treatment, time of NIPPV and the number of dead for the two groups （P〉0.05）. After treatment, the level of PaCO; was lower and the worth of PaO2/FiO2 was higher in the two groups （P;0.05）. Pressure support of the study group was significantly increased, the leak incidence, the number of initial treatment 24h interruption and the interrupt frequency of initial 24h treatment were significantly reduced（P〈 0.05）. The was significant difference in NIPP-related complications incidence between two groups （34.88 ; vs. 4.65%, respectively, P〈0.05）. Conclusion This study indicates that the helmet NIPPV treatment for patients with AECOPD was efficacy and tolerability, especially suitable for the type I combined with respiratory failure in patients with AECO- PD.

关 键 词：慢性阻塞性肺疾病 无创正压通气 临床疗效 

分 类 号：R563.8[医药卫生—呼吸系统]