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目的:探讨双水平气道正压通气在治疗慢性阻塞性肺疾病急性加重期并Ⅱ型呼吸衰竭伴轻度意识障碍患者中的价值和意义。方法:慢性阻塞性肺疾病急性加重期并Ⅱ型呼吸衰竭伴不同程度意识障碍患者65例,给予经面罩行双水平气道正压模式辅助通气,观察通气前,通气后2 h,1 d,2 d,3 d和治疗期间患者症状、体征、血气分析(pH、PaO2、PaCO2)结果、治疗效果及并发症。结果:经双水平气道正压通气治疗后明显好转63例(96.9%),pH、PaO2、PaCO2、心率、呼吸频率于治疗2 h有较大改善(P<0.01),1 d达明显效果,1～3 d仍进一步好转(P<0.01);2例无效(3.1%)。结论:双水平气道正压通气对慢性阻塞性肺疾病急性加重期并Ⅱ型呼吸衰竭伴轻度意识障碍患者疗效确切。
Objective: To investigate the value and significance of bi-level positive airway pressure ventilation in the treatment of patients with chronic obstructive pulmonary disease (COPD) with acute respiratory failure and type Ⅱ respiratory failure. Methods: Sixty-five patients with acute exacerbation of chronic obstructive pulmonary disease and type Ⅱ respiratory failure with varying degrees of disturbance of consciousness were given ventilator assisted by double-level positive airway pressure mode. The changes of airway pressure before and after ventilation were observed at 2 h, 1 d, 2 d, 3 d and symptoms, signs, blood gas analysis (pH, PaO2, PaCO2) results, treatment effect and complications during treatment. Results: Sixty-two cases (96.9%) were significantly improved after treatment with bilevel positive airway pressure. The pH, PaO2, PaCO2, heart rate and respiratory rate were significantly improved at 2 hours (P <0.01) (P <0.01); 2 cases were ineffective (3.1%). CONCLUSION: Biphasic positive airway pressure ventilation is effective in patients with acute exacerbation of chronic obstructive pulmonary disease and type Ⅱ respiratory failure with mild disturbance of consciousness.