BiPAP治疗AECOPD合并Ⅱ型呼吸衰竭的效果观察  

Analysis the clinical efficacy of Bi level positive airway pressure ventilation in treating chronic obstructive pulmonary diseases with typell respiratory failure

作　　者：黄坤[1] 闫芳[2] 克丽别娜.吐尔逊 黄相增[1] 

机构地区：[1]新疆医科大学第二附属医院呼吸科,830028 [2]新疆医科大学第一附属医院呼吸一科,830054

出　　处：《疑难病杂志》2014年第12期1236-1239,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的探讨双水平气道正压通气(BiPAP)对慢性阻塞性肺疾病急性加重期(AECOPD)合并II型呼吸衰竭患者的治疗效果。方法选取AECOPD合并II型呼吸衰竭患者120例分为2组,每组60例。2组均给予常规治疗,治疗组予以BiPAP,对照组予以持续低流量鼻导管吸氧,观察2组治疗前及治疗72 h的心率、呼吸频率、pH值、二氧化碳分压(PaC02)、氧分压(Pa02)、血氧饱和度(Sa02),以及平均住院时间。结果2组患者心率、呼吸频率、PaC02均较治疗前下降(P<0.01),pH值、Pa02、SaO,均较治疗前明显增加(P<0.01);且治疗组患者心率、呼吸频率、PaCO_2下降幅度明显高于对照组,Pa02、Sa02上升幅度明显高于对照组(P<0.01或P<0.05);治疗后2组pH值无明显差异(P>0.05)。平均住院时间对照组为(10.81±3.26)d,多于治疗组的(9.41±2.73)d,差异有统计学意义(P<0.05)。结论双水平气道正压通气对AECOPD合并II型呼吸衰竭患者的低氧血症及二氧化碳潴留有明显疗效,能改善氧合,缩短住院时间,值得推广。Objective To investigate the effect of Bi level positive airway pressure ventilation（BiPAP） on acute exacerbation of chronic obstructive pulmonary disease（AECOPD） patients with type II respiratory failure.Methods 120 patients with AECOPD complicated with type II respiratory failure were divided into 2 groups,60 cases in each group.TWO groups were given conventional treatment,the treatment group was given BiPAP,the control group was given continuous nasal catheter inhalation of low flow oxygen,before and after treatment,heart rate,respiratory frequency,pH72 h value of pressure,carbon dioxide（PaCO2）,partial pressure of oxygen（PaO_2）,oxygen saturation（SaO2）,and the average hospitalization time were observed in the 2 groups.Results The heart rate,respiratory frequency,PaCO_2 of the 2 groups were significantly reduced（P〈0.01）,pH value,PaO_2,SaO2 were significantly increased than before treatment（P〈0.01）;and the treatment group patients;heart rate,respiratory rate,PaCO2＇ s decline was significantly greater than the control group,PaO_2,SaO2 markedly increased than that of the control group（P〈0.01 or P 0.05）;no significant difference of pH values were found in the 2 groups after treatment（P 0.05）.The average duration time of the control group was（10.81 ±3.26） d,longer than the treatment group＇s（9.41 ±2.73） d,the difference was statistically significant（P 0.05）.Conclusion It suggested that BiPAP ventilation on patients with AECOPD complicated with hypoxemia,hypercapnia and type II respiratory failure has obvious curative effect,it can improve oxygenation,and shorten the time of hospitalization,worthy of promotion.

关 键 词：双水平气道正压通气 慢性阻塞性肺疾病 Ⅱ型呼吸衰竭 疗效 

分 类 号：R563.9[医药卫生—呼吸系统] R563.8[医药卫生—内科学]