双水平无创正压通气治疗COPDⅡ型呼吸衰竭的临床疗效分析

摘要

目的 探讨双水平无创正压(BiPAP)通气治疗COPDⅡ型呼吸衰竭的临床疗效.方法 98例 COPD 合并Ⅱ型呼吸衰竭随机分成治疗组和对照组各49例,每组同时予以常规治疗,治疗组予以BiPAP通气,而对照组加用呼吸兴奋剂治疗;监测两组治疗前后血气分析、呼吸频率、心率的变化,死亡率及平均住院时间.结果 治疗12小时后,治疗组动脉血气分析pH值、PaO2上升,PaCO2下降,同时可减慢患者呼吸频率、心率,与对照组相比较,其差异有统计学意义(P＜0.05); 两组死亡率分别是8.2%及18.4%,住院时间分别是11.1±4.5天及16.4±6.7天,差异有统计学意义(P＜0.05).结论 双水平无创正压通气治疗COPDⅡ型呼吸衰竭有显著疗效,可纠正患者的低氧血症和二氧化碳潴留,降低死亡率及平均住院时间.%Objective To investigate the clinical therapeutic effect of noninvasive bi-level positive airway pressure ( BiPAP ) ventilation in the treatment of patients with chronic obstructive pulmonary disease complicated with type Ⅱ respiratory failure. Methods 98 COPD patients complicated with type Ⅱ respiratory failure were randomly and evenly divided into the treatment group and the control group. All patients was given the conventional therapy. The treatment group was additionally treated with BiPAP, and the control group was given respiratory stimulants. Then the arterial blood gas, respiratory rate, heart rate, mortality and average duration of hospital stay were compared between the two groups. Results 12 hours after BiPAP treatment, the levels of pH value and PaO2 increased, and the level of PaCO2 decreased in the treatment group. At the same time, the rates of respiratory and heart were lower in the treatment group than in the control group with significant difference ( P < 0. 05 ). The mortality was 8. 2% and 18. 4% , and the average duration of hospital stay was 11. 1 ±4. 5 days and 16. 4 ±6. 7 days respectively in the treatment group and in the control group ( P < 0. 05 ). Conclusion Noninvasive bi-level positive airway pressure ventilation is an effective method in the treatment of COPD patients complicated with type Ⅱ respiratory failure, which can correct hypoxemia and carbon dioxide retention, and lower the mortality and duration of hospital stay.