慢性阻塞性肺疾病急性加重期伴神志改变患者无创通气疗效观察

摘要

Objective To estimate the effect of noninvasive positive pressure ventilation(NPPV)on patients suffering from acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with consciousness ahernative.Methods Fourty-three AECOPD patients with changes of consciousness were treated with NPPV and routine drugs.The changes of arterial blood gas and consciousness were analyzed.Results After 2 h and 8 h NPPV,Pa0,and GCS were higher and PaCO2 was lower (P＜0.01).Nine patients stopped NPPV because of no improvement.The reduction rate of intubation was 79.1%.Conclusion NPPV can be used in AECOPD patients complicated with consciousness ahernative by reducing the rate of intubation.%目的 研究面罩式无创正压通气(NPPV)在慢性阻塞性肺疾病急性加重期(AECOPD)合并神志改变患者中的治疗效果.方法 对43例反复发作的AECOPD伴昏迷患者进行NPPV治疗,观察其治疗前及治疗后2 h和8 h血气分析和神志变化.结果 治疗后34例患者血气分析及神志明显改善,pH值升高[(7.31±0.07)比(7.15±0.07)](P＜0.01),PaCO2水平降低[(53.97±10.58)比(81.82±8.35)](P＜0.01),PaO2水平升高[(73.85±13.07)比(65.79±5.25)](P＜0.01),有效率79.1%.9例患者由于病情无改善,停用NPPV,其中4例改为有创通气,5例拒绝有创通气,最终死亡.失败率20.9%(9/43).结论 无创通气可用于AECOPD合并神志改变者的治疗,可减少插管机会.