目的研究无创正压通气与常规吸氧治疗重症COPD急性发作期的临床疗效对比。方法将我院在2010年1月～2011年1月期间收治的78例重症COPD急性发作患者随机等分为两组，两组均进行常规的内科药物护理治疗，但实验组39例患者利用无创正压通气治疗，对照组利用常规吸氧治疗。对比两组患者的临床疗效并总结对此类患者的方法。结果治疗前两组患者血气分析无明显差异，治疗组pH值持续改善，但对照组pH值在4～24 h治疗后无明显改善；治疗组和对照组均呈现PaO2升高，PaCO2下降的变化趋势，但治疗组在治疗4 h、24 h、72 h对比对照组血气改善的程度明显，与治疗前相比pH、PaO2升高幅度增大，PaCO2下降幅度增加，差异有统计学意义（P＜0.05）。结论对于重症COPD急性发作患者，应在其急性发作期及时对其进行无创正压通气，可以明显改善患者的呼吸困难，挽救患者生命，值得临床广泛推广使用。%Objective To study the clinical efficacy of noninvasive positive pressure ventilation and conventional oxygen inhalation in treatment of severe acute exacerbation of COPD. Methods 78 cases of severe COPD in our hospital during 2010 January to 2011 in January were the acute attack were randomly divided into two groups,two groups were treated with conventional medicine nursing in Department of internal medicine, but the experimental group of 39 patients use noninvasive positive pressure ventilation in the treatment, control group using conventional oxygen therapy.The clinical effects were compared between the two groups of patients and summarize the nursing method for such patients. Results Blood gas analysis of 2 groups before treatment had no significant difference,the treatment group pH value of continuous improvement, but the control group pH value after 4~24h treatment had no obvious improvement;the treatment group and the control group showed increased PaO2,the decreasing trend of PaCO2,but the treatment group in the treatment of 4 h,24 h,72 h compared with the control group blood gas improvement obviously compared with before treatment,pH,PaO2 rise,PaCO2 amplitude decreased with increasing, the difference was statistically significant (P < 0.05). Conclusion For patients with acute episode of severe COPD,should be in the acute stage in time for its noninvasive positive pressure ventilation,can significantly improve the patient's breathing difficulties, to save the lives of patients, and it is worthy of extensive promotion.
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