摘要
目的评价双水平气道正压通气(BiPAP)呼吸机治疗慢性阻塞性肺疾病(COPD)合并呼吸衰竭的临床价值。方法将74例COPD合并呼吸衰竭患者随机分为对照组和试验组,对照组给予常规治疗,而试验组除常规治疗外还予以BiPAP呼吸机通气治疗,所有患者均分别在治疗前和BiPAP治疗6h及24h后测定血气指标(pH、PaO2及PaCO2)和肺功能指标[1秒用力呼气量(FEV1)及用力肺活量(FVC)],并记录临床症状的变化。结果(1)4d后对照组和试验组的临床症状改善率分别为91%和70%(P<0.05)。(2)BiPAP治疗6h及24h后,pH分别为(7.37±4.06)、(7.36±5.27),较对照组(7.33±4.53)、(7.34±3.95)明显好转(P<0.01);PaO2分别为(71.57±10.57)mmHg、(78.02±10.27)mmHg,均高于对照组(62.84±8.28)mmHg、(71.62±11.61)mmHg(P<0.01);PaCO2分别为(58.54±7.25)mmHg、(54.35±8.43)mmHg,均低于对照组(63.64±9.93)、(61.22±5.19)mmHg(P均<0.01);FVC分别为(1.74±0.48)L、(1.76±0.48)L,均高于对照组(1.50±0.52)L、(1.52±0.49)L(P均<0.05),而FEV1分别为(0.84±0.25)L、(0.86±0.24)L,与对照组(0.83±0.22)L、(0.84±0.26)L比较无明显差异(P均>0.05)。结论早期应用BiPAP呼吸机治疗COPD合并呼吸衰竭能更快的改善呼吸衰竭。
Objective To investigate the clinical significance of BiPAP mechanical ventilation on chronic obstructive pulmonary diseases （COPD） complicated with type Ⅱ respiratory failure. Methods Seventy-four patients with COPD complicated with type Ⅱ respiratory failure were randomly divided into two groups （ experimental group and control group）, with 37 in each group. The experimental group received routine treatment, and was also treated with BiPAP mechanical ventilation. While the control group only received routine treatment. Blood gas parameters including pH, PaO2 ,PaCO2 and lung function parameters including FVC and FEV1 were recorded before and after the ventilation. Results （ 1 ） After four days＇ treatment ,the effective rate of symptom in experimental group was higher than that in control group （91% vs 70%, P 〈0. 05）. （2） After 6 h and 24 h of BiPAP mechanical ventilation,the values of pH[ （7.37 ±4. 06） vs （7.33 ±4. 53） , （7.36±5.27） vs （7.34 ±3.95）, P〈0.01], PaO2[（71.57 ±10.57） vs （62.84 ±8.28）,（78.02±10.27） vs （71.62±11.61）,P〈0.01], PaCO2[（58.54 ±7.25） vs （63.64 ±9.93）,（54.35±8.43） vs （61.22±5.19）, P 〈 0. 01 ] , and FVC [ （ 1.74 ± 0. 48 ） vs （ 1.47 ± 0. 49） , （ 1.76 ± 0. 48） vs （ 1.52 ± 0. 49） , P 〈 0.05 ] in the experimental group were all improved significantly as compared with those of control group. There were no significant differences before and after non-invasive ventilation in FEV1 [ （0. 84 ± 0. 25 ） vs （0. 83 ± 0.22） , （0. 86 ± 0. 24） vs （0. 84 ± 0. 26） , P 〉 0. 05 ]. Conclusions Using early BiPAP respiratory ventilation can heighten arterial oxygen tension, lower PaCO2 and improve lung funtion in the treatment of COPD patients who suffer from type Ⅱ respiratory failure.
出处
《实用老年医学》
CAS
2007年第1期49-51,共3页
Practical Geriatrics
关键词
机械通气机
慢性阻塞性肺疾病
呼吸功能不全
mechanical ventilators
chronic obstructive pulmonary disease
respiratory disorder
