论文部分内容阅读
目的观察BiPAP无创通气联用呼吸兴奋剂治疗慢阻肺呼吸衰竭(Ⅱ型)并肺性脑病患者的疗效。方法将2004年1月-2008年12月收治的32例慢阻肺Ⅱ呼衰并肺性脑病患者随机分为治疗组和对照组,治疗组采用呼吸兴奋剂、鼻罩无创正压通气及常规治疗;对照组采用鼻罩无创正压通气和常规治疗。通气前、通气2h及通气结束病情稳定后复查动脉血气分析。结果治疗组16例患者中14例治疗成功,另外2例病情加重需气管插管机械通气治疗;对照组16例患者中9例治疗成功,7例需要气管插管机械通气治疗。治疗组气管插管率明显低于对照组(P<0.05)。治疗组14例治疗成功患者BiPAP无创通气治疗前后pH、PaCO2明显下降、PaO2显著升高。结论BiPAP无创通气联用呼吸兴奋剂治疗慢阻肺呼吸衰竭合并肺性脑病患者可以提高BiPAP无创通气的疗效,减少患者的气管插管率。
Objective To observe the efficacy of BiPAP non-invasive ventilation combined with respiratory stimulant in the treatment of COPD patients (type Ⅱ) with pulmonary encephalopathy. Methods A total of 32 COPD patients with pulmonary encephalopathy who were admitted from January 2004 to December 2008 were randomly divided into treatment group and control group. The treatment group was treated with respiratory stimulant, nasal mask noninvasive positive pressure ventilation and routine The control group received nasal mask non-invasive positive pressure ventilation and routine treatment. Ventilation before ventilation 2h and after the end of ventilation stable condition after review of arterial blood gas analysis. Results Of the 16 patients in the treatment group, 14 were successfully treated and the other 2 were exacerbated by mechanical ventilation with tracheal intubation; 9 of 16 patients in the control group were successfully treated and 7 required mechanical ventilation through tracheal intubation. The rate of tracheal intubation in the treatment group was significantly lower than that in the control group (P <0.05). Before and after BiPAP noninvasive ventilation in 14 patients in the treatment group, PaCO2 and PaO2 were significantly decreased before and after treatment, PaO2 significantly increased. Conclusion BiPAP noninvasive ventilation combined with respiratory stimulant in the treatment of COPD patients with pulmonary encephalopathy can improve the efficacy of BiPAP noninvasive ventilation and reduce the rate of tracheal intubation.