经鼻双水平气道正压通气治疗慢阻肺并多发性肺大泡的观察  

BiPAP Respirator Assisted Ventilation Trans-Nasal Facial Mask in the Treatment of Acute Respiratory Failure of Chronic Obstructive Pulmonary Disease and Multi-Pneumatocele

作　　者：杨蓉美[1] 张玉兰[1] 

机构地区：[1]江西省肺科医院呼吸科,江西南昌330006

出　　处：《实用临床医学（江西）》2003年第4期51-53,共3页Practical Clinical Medicine

摘　　要：目的 :观察无创双水平气道正压通气 (BiPAP)呼吸机辅助通气治疗慢性阻塞性肺疾病 (COPD)急性呼吸衰竭合并多发性肺大泡患者的疗效。方法 :确诊的 14例COPD急性呼吸衰竭合并多发性肺大泡患者给予无创BiAP通气治疗 ,参数吸气压 (IPAP)自 4～ 6cmH2 O(1cmH2 O =0 .0 98kPa)开始 ,在 5～ 30min内调至 10～ 14cmH2 O ,呼气压 (EPAP) 2～ 4cmH2 O ,氧流量 2～ 5L/M ,每日持续或间断通气 8h以上。结果 :治疗 5d后全身症状及动脉血气改善明显 ,血气主要指标PaO2 (48.2± 11)mmHg ,PaCO2 (83.8± 16 .5 )mmHg ,治疗后分别为PaO2 (6 8.1± 10 )mmHg ,PaCO2 (5 8.2± 11)mmHg ,分别与治疗前相比 ,差异均有显著性 (P <0 .0 1)。结论 :COPD急性呼吸衰竭合并多发性肺大泡患者采用无创BiPAP通气治疗疗效肯定 ,总有效率 92 .8% (13/ 14 ) ;对于合并有相对禁忌症如 :多发性肺大泡 ,重度肺气肿的COPD患者 ,只要调节合适的参数 。Objective: To evaluate the efficacy of Noninvasive BiPAP assisted ventilation in the treatment of acute respiratory failure of COPD and multi pneumatocele.Methods:Forteen patients with the diseases were received Noninvasive BIPAP AV by nasal facial mask,IPAP from 4～6 cmH 2O(1 cmH 2O=0.098 kPa),and followed using 10～14 cmH 2O between 5～30 minutes,EPAP 2～4 cmH 2O,Oxygen flow 2～5 L/M,for eight hours or more daily.Results:There were significant difference in clinical symptoms and ABGS(PaO 2,PaCO 2)between pre and post treatment.before BiPAP AV,PaO 2 was(48.2±11)mmHg and PaCO 2 was(83.8±16.5)mmHg; after 5 days of BiPAP AV,PaO 2 was(68.1±10)mmHg and PaCO 2 was(58.2±11)mmHg( P <0.01),respectively. The total efficiency rate is 92.8%(13/14).Conclusion:The efficacy of Noninvasive BiPAP assisted vention in the teatment of acute respiratory failure in COPD and multi pneumatocele is marked positive,and pneumothorax would not occur provided that a suitable paramete is used.

关 键 词：肺疾病 阻塞性 无创机械通气 肺大泡 多发性 

分 类 号：R563[医药卫生—呼吸系统]