目的:观察BiPAP呼吸机对不同AECOPD合并呼吸衰竭患者的疗效,分析其治疗机制及适用范围.方法:从2009年10月至2011年10月收集AECOPD合并呼吸衰竭患者62例,分为对照组及治疗组,其中治疗组再根据APACHEⅡ评分分为低分值组(n=18)、中分值组(n=17)及高分值组(n=15).治疗7d,观察疗效.结果:治疗2h后,对照组的疗效较治疗前无明显差异(P＞0.05),而治疗组的PaO2与PaCO2有明显改善(P＜0.05);治疗24h后及7d后,各组的疗效及生命体征均较治疗前有明显改善(P＜0.05);治疗组的疗效要优于对照组,两者差异明显(P＜0.05);低分值组的疗效略高于中分值组,且低分值组与中分值组的疗效明显高于高分值组(P＜0.05).结论:BiPAP对于AECOPD合并呼吸衰竭的患者疗效显著,但对APACHEⅡ评分较高的患者需做好行常规机械通气的准备.%Objective: To observe the curative effect of different patients of AECOPD combined with respiratory failure by BiPAP ventilator, analyze the treatment mechanism and application scope. Method:From Oct. 2009 to Oct. 2011 , we collected 62 cases of AECOPD combined with respiratory failure, and divided into control group and treatment group, which treatment group was further divided according to APACHE II score into low score group ( n = 18 ), the score group ( n = 17 ) and high score group ( n = 15 ). Observed the curative effect in 7days. Result: 2 hours after treatment, the efficacy of the control group no significant difference compared with before treatment ( P> 0. 05 ), while the treatment group, PaO2 and PaCO2 significantly improved ( P <0.05 ); after 24 hours and 7 days after treatment, the efficacy of each group and vital signs a significant improvement compared with before treatment ( P <0.05 ); to the efficacy of the treatment group than the control group, the difference was ( P <0. 05 ); low scores in the group score slightly higher than the efficacy of group and low score value set with the score group was significantly higher than the efficacy of high-score group ( P <0. 05 ). Conclusion: BiPAP for respiratory failure in patients with AECOPD is effective, but patients with higher APACHE II score need to do to prepare by conventional mechanical ventilation.
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