论文部分内容阅读
目的:评价无创正压通气(NIPPV)在救治慢性阻塞性肺疾病(COPD)急性加重期并严重呼吸衰竭患者中的临床疗效。方法:对2006年1月至2008年1月入选的47例COPD急性加重期并严重呼吸衰竭患者使用双水平无创正压呼吸机面罩辅助通气,患者均伴有不同程度的意识障碍,动态观察NIPPV治疗前和治疗后2 h、8 h、1 d及3 d动脉血气、神志、治疗后患者的转归,NIPPV的不良反应及并发症。结果:本组47例患者中,41例经NIPPV治疗2h8、h、1 d及3 d后与治疗前比较,PaO2明显升高P<0.01,PaCO2明显降低P<0.01,pH明显升高P<0.01,均脱机出院,有效率达87.23%(41/47);6例改为有创通气,其中3例经有创机械通气治疗后脱机成功,1例因上消化道出血死亡,2例自动出院。结论:双水平无创正压通气对有选择的COPD急性加重期并严重呼吸衰竭患者治疗疗效确切,它能迅速缓解病情,减少患者的气管插管和气管切开以及相应的并发症,提高生活质量。
Objective: To evaluate the clinical efficacy of noninvasive positive pressure ventilation (NIPPV) in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) and severe respiratory failure. Methods: Forty-seven patients with acute exacerbation of COPD and severe respiratory failure from January 2006 to January 2008 were enrolled in this study. Two-level non-invasive positive pressure ventilator mask-assisted ventilation was used. All patients were accompanied with varying degrees of disturbance of consciousness. NIPPV Arterial blood gas, consciousness, prognosis of patients after treatment, 2 h, 8 h, 1 d and 3 d after treatment, adverse reactions and complications of NIPPV. Results: Among the 47 patients in this study, PaO2 significantly increased (P <0.01), PaCO2 decreased significantly (P <0.01) and pH increased significantly (P < 0.01, were discharged off-line, the effective rate was 87.23% (41/47); 6 cases were changed to invasive ventilation, 3 of them were successfully treated with invasive mechanical ventilation, 1 died of upper gastrointestinal bleeding, 2 Cases were discharged automatically. CONCLUSIONS: Bi-level noninvasive positive pressure ventilation is effective in the treatment of patients with acute exacerbation of COPD and severe respiratory failure. It can quickly relieve the condition, reduce tracheal intubation and tracheotomy and the corresponding complications, and improve the quality of life .