双水平气道正压联合无创机械通气治疗慢性阻塞性肺部疾病合并呼吸衰竭的临床疗效分析  

The clinical curative effect of Bi PAP combined NIV treatment of COPD with respiratory failure

作　　者：邵剑骏[1] 张思泉 SHAO Jian-jun ZHANG Si-quan(Department of Respiratory Medicine, The second hospital of Jiaxing in Zhejiang Province, Zhejiang Jiaxing 314000, China Department of lCU, Xixi Hospital of Hangzhou City in Zhejiang Province, Zhejiang Hangzhou 310023, China)

机构地区：[1]浙江省嘉兴市第二医院呼吸内科,浙江嘉兴314000 [2]浙江省杭州市西溪医院重症监护室,浙江杭州310023

出　　处：《中国医刊》2017年第1期46-48,共3页Chinese Journal of Medicine

基　　金：浙江省医药卫生一般研究计划(2013KYA170)

摘　　要：目的采取双水平气道正压(bi-level positive airway pressure,Bi PAP)通气联合无创机械通气(non-invasive ventilation,NIV)对慢性阻塞性肺部疾病(chronic obstructive pulmonary disease,COPD)合并呼吸衰竭进行治疗,分析取得的临床疗效。方法选取2013年12月至2014年12月于浙江省嘉兴市第二医院被确诊为慢性阻塞性肺部疾病合并呼吸衰竭的100例患者,随机将患者分为试验组和对照组,每组各50例,对照组采取常规的药物治疗;试验组在常规药物的基础上采取Bi PAP联合NIV进行治疗,观察比较两组的临床疗效。结果试验组患者治疗后动脉血氧分压[(9.55±1.05)k Pa]、p H(7.30±0.04)、二氧化碳分压[(6.47±1.20)k Pa]、呼吸频率[(20.40±3.97)次/分]及心率[(90.20±6.87)次/分]均较对照组有显著改善,差异具有显著性(P<0.05),血压没有显著改善,差异无显著性(P>0.05)。结论对于慢性阻塞性肺部疾病合并呼吸衰竭的患者,临床上采取Bi PAP联合NIV对慢性肺阻塞疾病合并呼吸衰竭疗效显著,能有效改善患者的生命体征、呼吸状况和血气指标,值得临床进一步推广。Objective To take double the level of positive airway pressure（Bi PAP） ventilation noninvasive mechanical ventilation（NIV） on chronic obstructive pulmonary disease（COPD） respiratory failure treatment, the clinical curative effect analysis. Method Select the December 2013-December 2014 were treated in our hospital respiratory medicine was diagnosed with chronic obstructive pulmonary disease and respiratory failure in 100 cases, patients were randomly divided into experimental and control groups, each group 50 cases, the control group received conventional medical treatment; experimental group take joint NIV Bi PAP treatment on the basis of conventional drugs, compare the clinical efficacy of the two groups was observed. Result The experimental group of arterial blood oxygen partial pressure（9.55±1.05） k Pa, p H（7.30±0.04 mm）, CO2 partial pressure（6.47±1.20）k Pa,respiratory frequency（20.40±3.97）times/min and heart rate（90.20±6.87） times/min have improved significantly than control group, with statistical significance（P〈0.05）, blood pressure were not significantly improved, no statistical significance（P〉0.05）. Conclusion Chronic obstructive pulmonary disease complicated by respiratory failure patients take clinically Bi PAP United NIV for patients with respiratory failure effect of chronic obstructive pulmonary disease significantly, can effectively improve the patient＇s vital signs, respiratory status and blood gas analysis, worthy of further promotion.

关 键 词：双水平气道正压 慢性阻塞性肺部疾病 呼吸衰竭 无创机械通气 

分 类 号：R56[医药卫生—呼吸系统]