摘要
目的观察双水平无创正压通气对慢性阻塞性肺病(COPD)并发严重呼吸衰竭患者的治疗作用。方法B IPAP呼吸机对33例COPD伴Ⅱ型呼吸衰竭患者在常规治疗同时进行无创通气(IPAP 18±2.3cmH2O,EPAP 3±0.2cmH2O)治疗。观察治疗前及治疗后3h、24h、3d、治疗结束后1h的动脉血气及临床变化。结果33例患者2例放弃治疗,1例死亡。其余患者机械通气治疗后意识恢复正常;SaO2逐渐升高,3小时时Pao2明显升高(P<0.01),PaCO2明显下降(P<0.05),24小时潮气量明显增加;停机间歇心率、呼吸频率逐渐增加、SaO2逐渐下降,再上机后逐渐恢复。结论B IPAP对COPD并严重呼吸衰竭疗效肯定,无严重不良反应。
Objective To estimate the efficacy of noninvasive positive pressure ventilation in COPD with severe hypercapnic respiratory failure. Methods 33 COPD cases with severe hypercapnic respiratory failure were treated by hi-level noninvasive positive-pressure ventilation （IPAP 18＋2.3cmH2O, EPAP3±0. 2 cmH2O） and routine treatment. Observation was made on the clinical symptoms and changes of arterial blood gas before and after 3h, 24h, 3d ventilation and lh after the treatment. Results Among 33 cases, 2 patients dropped off and one case died. After ventilation, patients＇ symptoms of pulmonary encephalopathy and unconsciousness improved markedly. SaO2 improved since the ventilation. 3 hours later, the patients experienced elevated PaO2 and decreased PaCO2, which was better than before the treatment （P〈0.01, P〈0.05 respectively）. 24 hours later, tidal volume increased significantly. Pause interval of heart beat, and breath rate increased and SaO2 decreased. They were improved at secondtime ventilation. Conclusion In COPD patients with severe hypercapnic respiratory failure, bi-level positive airway pressure （BiPAP） noninvasive ventilation is effective with few serious complications.
出处
《临床肺科杂志》
2005年第6期709-711,共3页
Journal of Clinical Pulmonary Medicine
