老年慢性阻塞性肺疾病合并呼吸衰竭患者应用无创通气的疗效分析

摘要

Objective To explore the clinical effect of non‐invasive positive pressure ventilation (NIPPV) on the treatment of respiratory failure resulting from acute exacerbation of chronic obstructive pulmonary disease . Methods Ninty‐two patients were retrospectively analyzed and divided at random into conventional therapy group (control group) and conventional therapy plus NIPPV group .We observed the blood gas analysis before mechani‐cal ventilation ,2 ,24 and 72 h after mechanical ventilation and discharge ,intubation rate ,in‐hospital mortality , duration of hospitalization.Results There was significant difference in the blood gas analysis after therapy be‐tween the NIPPV group and contral group .Intubation rate and mortality were significantly lower in NIPPV group than those in the control group ( P <0 .05) .Conclusion The application of NIPPV is effective in the AECOPD patients ,especially elder patients.%目的：对无创正压通气（NIPPV）在高龄老年慢性阻塞性肺疾病急性加重期合并呼吸衰竭患者的疗效分析，进而探讨其临床应用时机。方法回顾性分析92例慢性阻塞性肺疾病急性加重期合并呼吸衰竭老年患者分为常规治疗组和常规治疗＋NIPPV治疗组，观察其治疗前（0 h）、治疗后2、24、72 h的动脉血气分析变化，观察住院天数、气管插管率、病死率。结果 NIPPV组治疗后血气分析明显改善，2组比较 NIPPV组治疗后动脉血氧分压（PaO2）较常规组明显升高，后期插管率、住院病死率均显著低于常规组，差异有统计学意义（ P ＜0.05）。结论 NIPPV治疗慢性阻塞性肺疾病急性加重期合并呼吸衰竭疗效确切，尤其针对高龄老年患者是临床有效的治疗方法。