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目的 应用双水平正压通气 (BiPAP)呼吸机治疗慢性阻塞性肺病 (COPD)伴Ⅱ型呼衰。方法 分通气组和对照组 ,对照组给予常规抗感染、祛痰、平喘、低浓度持续吸氧等治疗 ,通气组除常规治疗外 ,加用Bi PAP呼吸机治疗 ,选择合适鼻罩 ,设定参数S/T模式 ,呼吸频率 16次 /min ,呼气压 3～ 4cmH2 O ,吸气压渐增大至 10～ 15cmH2 O ,通气时间 3～ 5d ,每天 2次 ,每次 3h。结果 加用BiPAP呼吸机治疗除可提高PaO2 减轻呼吸机疲劳 ,使呼吸频率和心率减慢 ,呼吸困难减轻。结论 BiPAP呼吸机无创通气治疗对COPD合并Ⅱ型呼衰早、中期患者疗效较好 ,可减少气管插管或气管切开以及相应并发症 ,减少患者痛苦和医疗费用 ,提高生活质量。
Objective To treat chronic obstructive pulmonary disease (COPD) with type Ⅱ respiratory failure by bi-level positive pressure ventilation (BiPAP) ventilator. Methods The patients in the ventilation group and the control group were given conventional anti-infective, expectorant, antiasthmatic and continuous low-concentration oxygen inhalation therapy. The ventilation group was treated with Bi PAP ventilator, and the proper nasal mask was selected. The parameters S / T mode, breathing rate 16 times / min, expiratory pressure 3 ~ 4cmH2O, inspiratory pressure gradually increased to 10 ~ 15cmH2O, ventilation time 3 ~ 5d, 2 times a day, each time 3h. The results with BiPAP ventilator treatment can increase PaO2 reduce ventilator fatigue, respiratory rate and heart rate slowed, reduced breathing difficulties. Conclusion BiPAP ventilator noninvasive ventilation is effective in patients with COPD complicated with type Ⅱ respiratory failure in early and mid-term, which can reduce endotracheal intubation or tracheotomy and its complications, reduce patients’ pain and medical costs, and improve quality of life.