COPD合并Ⅱ型呼吸衰竭早期BIPAP无创通气治疗的价值(1)
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【摘要】 目的 观察双水平正压无创通气(BiPAP)治疗慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭(呼衰)的早期治疗效果。方法 80例COPD Ⅱ型呼衰患者中随机分成通气组和对照组，对照组给予常规抗感染、平喘、祛痰对症治疗和低浓度氧疗，治疗组除了常规治疗外，加无创机械通气(BiPAP)治疗，采用通气口鼻面罩，采用S/T(自主呼吸定时模式)，氧流量1.5～3.0 L/min。吸气压(IPAP)由6～8 cmH2O逐渐增加到14～20 cm H2O；呼气压(EPAP)设定为4～6 cm H2O。通气时间为每次3 h，2～3次/d。结果 治疗组上机24 h后心率及呼吸频率减慢，与治疗前比较，差异有统计学意义(P<0.05)。治疗后治疗组和对照组pH、PaO2 和SaO2均升高，PaCO2下降，与治疗前相比，差异有统计学意义(P<0.05)；治疗组治疗后PaO2、SaO2升高与PaCO2下降的差值均高于对照组 (P<0.05)。无严重的不良反应。结论 无创双水平气道正压力通气(BiPAP)是治疗COPD合并Ⅱ型呼吸衰竭的早期治疗经济、有效的方法。
【关键词】
慢性阻塞性肺疾病(COPD)；Ⅱ型呼吸衰竭；BiPAP呼吸机；无创机械通气
Early BIPAP value of non-invasive ventilation in the treatment of COPD with type Ⅱ respiratory failure
XIE Hao, PENG Min, WU Ge-yi. The Second Affiliated Hospital of Guangdong Medical College,Zhanjiang,524003 China
【Abstract】 Objective Observe the effect of early treatment of two-level positive airway pressure non-invasive ventilation(BiPAP) in chronic obstructive pulmonary disease(COPD) with type Ⅱ respiratory failure.Methods 80 patients with COPD Ⅱ type of respiratory failurewere randomly divided into ventilation group and the control group，control group received routine anti-infective,anti-asthmatic,expectorant,and low concentrations of oxygen therapy in symptomatic treatment，inaddition to conventional treatment，teatment group added non-invasive mechanical ventilation (BiPAP) therapy, used nose and mouth with mask ventilation and S/T(Self-timer mode breathing), oxygen flow was 1.5～3.0 L/min.Inspiratory pressure(IPAP)gradually increased from the 6～8 cm H2O to 14～20 cm H2O, expiratory pressure (EPAP) set to 4～6 cmH2O, ventilation time for each 3 h,2 to 3 times a day. Results Treatment group after 24 h on heart rate and respiratory rate showed down, compared with before treatment, there were significantstatistically differences(P<0.05).After treatment, treatment group and control group pH, PaO2 and SaO2 were increased, PaCO2 decreased, compared with before treatment, there were significant statistically differences(P<0 ......
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