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目的研究无创正压通气(NIPPV)治疗慢性阻塞性肺疾病(COPD)急性加重期并Ⅱ型呼吸衰竭的疗效。方法将68例慢性阻塞性肺疾病(COPD)急性加重期并Ⅱ型呼吸衰竭的患者随机分为对照组34例(常规治疗)和NIPPV治疗组34例(常规治疗基础上,经鼻(面)罩双水平气道正压BiPAP辅助通气)。比较两组患者通气前、通气后2h及24h后pH、PaO2、PaCO2、心率和呼吸频率的变化。结果治疗24h后,NIPPV治疗组和对照组pH、PaO2、PaCO2、心率和呼吸频率均有明显改善,并且NIPPV治疗组明显优于对照组(P<0.05)。结论NIPPV可明显改善COPD急性加重期并发Ⅱ型呼吸衰竭患者的pH、PaO2、PaCO2、心率和呼吸频率,值得临床推广。
Objective To study the efficacy of noninvasive positive pressure ventilation (NIPPV) in the treatment of acute exacerbation of chronic obstructive pulmonary disease (COPD) and type Ⅱ respiratory failure. Methods Sixty-eight patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) and type Ⅱ respiratory failure were randomly divided into control group of 34 patients (routine treatment) and NIPPV-treated group of 34 patients (routine treatment, nasal (surface) Cover bi-level positive airway pressure BiPAP assisted ventilation). The changes of pH, PaO2, PaCO2, heart rate and respiration rate were compared before and 2h and 24h after ventilation in both groups. Results After 24 hours treatment, the pH, PaO2, PaCO2, heart rate and respiratory rate of NIPPV treatment group and control group were significantly improved, and NIPPV treatment group was significantly better than the control group (P <0.05). Conclusion NIPPV can significantly improve the pH, PaO2, PaCO2, heart rate and respiratory rate in patients with COPD exacerbation complicated with respiratory failure type Ⅱ, which is worthy of clinical promotion.