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目的探讨双水平气道正压无创通气(BiPAP)对慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease,COPD)合并Ⅱ型呼吸衰竭的治疗价值。方法将46例COPD合并Ⅱ型呼衰患者分成通气组和对照组,对照组给予常规抗感染、解痉平喘、激素、吸氧等综合治疗,通气组除了常规治疗外,还给予无创机械通气(BiPAP)治疗,两组分别在治疗前、治疗4h和24h作血气分析检查,并对两组的pH值、SaO2、PaO2、PaCO2的变化,以及临床症状改善情况做一比较。结果 46例患者均能配合治疗,取得了较为满意的临床疗效。通气组治疗后患者的症状和体征以及血气分析中pH值、SaO2、PaO2、PaCO2较治疗前均明显改善,其改善幅度明显优于对照组。结论双水平气道正压无创通气治疗COPD合并Ⅱ型呼吸衰竭疗效显著。因此,对于临床稳定、仍需长期机械通气的呼吸衰竭患者,使用BiPAP无创呼吸机通气是可选择的方法。
Objective To investigate the therapeutic effect of bi-level positive airway pressure (BiPAP) on chronic obstructive pulmonary disease (COPD) with type Ⅱ respiratory failure. Methods 46 patients with COPD and type Ⅱ respiratory failure were divided into ventilation group and control group. The control group was given routine anti-infective, antispasmodic and antiasthmatic effects, hormones and oxygen inhalation. The ventilation group was given non-invasive mechanical ventilation (BiPAP ), Two groups before treatment, treatment 4h and 24h for blood gas analysis examination, and the two groups of pH, SaO2, PaO2, PaCO2 changes, and clinical symptoms to make a comparison. Results All 46 patients were able to cooperate with the treatment and achieved satisfactory clinical efficacy. Symptoms and signs of patients after ventilation group and blood gas analysis of pH, SaO2, PaO2, PaCO2 significantly improved than before treatment, the improvement was significantly better than the control group. Conclusion Biphasic positive airway pressure noninvasive ventilation is effective in treating COPD with type Ⅱ respiratory failure. Therefore, BiPAP noninvasive ventilator ventilation is an option for patients with respiratory failure who require long-term mechanical ventilation for clinical stabilization.