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目的总结和探讨无创通气治疗COPD合并呼吸衰竭的疗效和可控因素。方法将2007-01-2009-12我院收治的COPD合并呼吸衰竭53例患者采用BiPAP呼吸机进行NIPPV治疗,通气模式S/T,备用呼吸频率12~16次/min,FiO230%~60%,初始参数:呼气压4 cm H2O,吸气压8~10 cm H2O,初始PEEP 3~5cm H2O。观察治疗前12 h2、4 h、48 h和结束时血气变化。结果通气前12 h、24 h、48 h,结束时,PaO2明显升高,PaCO2明显下降(P<0.01),pH值改善(P<0.05)临床症状减轻或消失快,痊愈率高,无一例气管插管。结论 NIPPV治疗COPD合并呼吸衰竭疗效确切,妥善调整可控因素可提高NIPPV的疗效。
Objective To summarize and discuss the efficacy and controllable factors of noninvasive ventilation in treating COPD with respiratory failure. Methods Fifty-seven patients with COPD and respiratory failure admitted to our hospital from January 2007 to December 2009 were treated with NIPPV with BiPAP ventilator. Ventilation mode S / T, standby respiratory rate 12 ~ 16 times / min, FiO230% ~ 60% Initial parameters: breath pressure 4 cm H2O, suction pressure 8 ~ 10 cm H2O, the initial PEEP 3 ~ 5cm H2O. Blood gas changes were observed before 12 h, 4 h, 48 h and at the end of treatment. Results At the end of 12 h, 24 h and 48 h before ventilation, PaO2 was significantly increased, PaCO2 was significantly decreased (P <0.01), pH value was improved (P <0.05), clinical symptoms were relieved or disappeared, and the cure rate was high Tracheal intubation. Conclusion NIPPV is effective in treating COPD with respiratory failure. Adjusting controllable factors can improve the efficacy of NIPPV.