摘要
目的 探讨双水平气道正压无创通气（BiPAP）在慢性阻塞性肺疾病急性加重期（AECOPD）伴Ⅱ型呼吸衰竭中的临床疗效.方法 将2012年1月至2013年1月在武汉大学人民医院重症医学科住院治疗的AECOPD伴Ⅱ型呼吸衰竭的120例患者,采用随机数字表法分为吸氧治疗组和呼吸机组,各60例.在常规治疗的基础上,吸氧治疗组60例给予1 ～2 L/min低流量吸氧;呼吸机组60例给予BiPAP呼吸机辅助治疗,比较两组患者的血气分析指标、插管率及临床效果.结果 两组患者血0气分析中的pH值、氧分压和二氧化碳分压值较治疗前均明显改善（P＜0.05）;呼吸机组的有效率达91.67％,显著高于吸氧治疗组的76.67％（P＜0.05）;而气管插管率及病死率低于吸氧治疗组（8.33％ vs 26.67％）、（1.67％ vs 11.67％）,差异有统计学意义（P＜0.05）.结论 使用BiPAP呼吸机治疗时,血气分析改善迅速、预后良好,值得在临床中推广,但需注意呼吸衰竭的严重程度.
Objective To explore the clinical efficacy of bi-level positive airway pressure （BiPAP） noninvasive ventilation in patients with chronic obstructive pulmonary disease with acute exacerbation （AECO- PD） combined with type Ⅱ respiratory failure. Methods A total of 120 patients with AECOPD combined with type Ⅱ respiratory failure treated and hospitalized at the Critical Care Medicine Department of People＇s Hospital of Wuhan University during Jan. 2012 and Jan. 2013 were included,, they were randomly divided into oxygen therapy group and ventilator group by random balloting method,60 cases in each group. On the basis of conventional therapy, oxygen therapy group was given 1-2 L/min low-flow oxygen ; ventilator group was treated with BiPAP ventilator-assisted therapy. The blood gas analysis, intubation rate and clinical results of the two groups were compared. Results The pH value of blood gas analysis, oxygen and carbon dioxide partial pressure values of the two groups were significantly improved compared with before treatment （P 〈0.05 ） ;effective rate of the ventilator group was 91.67%, significantly higher than the 76.67% of the oxygen therapy group （ P 〈 0.05 ） ; while endotracheal intabation rate and mortality were lower than oxygen therapy group, with statistically significant differences [ （ 8.33% vs 26. 67% ）, （ 1.67% vs 11.67% ）, （ P 〈 0.05 ） ]. Conclusion BiPAP ventilation therapy enables blood gas analysis to improve rapidly,with good prognosis,thus is worthy of promotion in clinical,while the severity of respiratory failure should be noticed.
出处
《医学综述》
2014年第13期2436-2438,共3页
Medical Recapitulate
关键词
慢性阻塞性肺疾病
急性加重期
呼吸衰竭
无创正压通气
Chronic obstructive pulmonary disease
Acute exacerbation
Respiratory failure
Noninvasive positive pressure ventilation
