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目的探讨无创通气在慢性阻塞性肺疾病(COPD)急性发作伴呼吸衰竭中的应用。方法将50例COPD急性加重合并Ⅱ型呼吸衰竭患者随机分为对照组和实验组,每组25例。对照组用常规药物治疗,实验组用常规药物加无创正压通气治疗。结果两组患者治疗前的基础情况和血气指标差异无统计学意义(P>0.05)。治疗后实验组呼吸频率(RR)、心率(HR)、动脉血pH、氧分压(PaO2)、二氧化碳分压(PaCO2)均明显改善(P<0.05),但实验组与对照组比较,治疗后PaO2上升更明显(P<0.01),PaCO2下降更明显(P<0.01)。治疗48 h后,实验组和对照组呼吸困难明显缓解的人数分别为22例和13例(P<0.05)。实验组和对照组平均住院日分别为(12±5)d和(18±6)d(P<0.01)。结论无创通气治疗COPD急性发作伴呼吸衰竭较仅用常规药物治疗能更快地缓解临床症状,提高PaO2和降低PaCO2。
Objective To explore the application of noninvasive ventilation in acute exacerbation of chronic obstructive pulmonary disease (COPD) with respiratory failure. Methods Fifty patients with acute exacerbation of COPD and type Ⅱ respiratory failure were randomly divided into control group and experimental group, with 25 cases in each group. The control group with conventional drug treatment, experimental group with conventional drugs plus noninvasive positive pressure ventilation treatment. Results There was no significant difference in basal condition and blood gas index between the two groups before treatment (P> 0.05). After treatment, the respiratory rate (RR), heart rate (HR), arterial blood pH, PaO2 and PaCO2 in the experimental group were significantly improved (P <0.05), but the experimental group and the control group After PaO2 increased more significantly (P <0.01), PaCO2 decreased more significantly (P <0.01). After 48 h of treatment, the number of patients with significant dyspnea in the experimental group and the control group were 22 and 13 (P <0.05), respectively. The average length of stay in the experimental and control groups was (12 ± 5) days and (18 ± 6) days, respectively (P <0.01). Conclusion Noninvasive ventilation for acute exacerbation of COPD with respiratory failure can relieve clinical symptoms, improve PaO2 and reduce PaCO2 more quickly than conventional drugs.