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[目的]分析应用无创正压通气(NPPV)治疗慢性阻塞性肺疾病急性加重(AECOPD)合并呼吸衰竭患者的临床疗效。[方法]回顾性分析2009年6月～2010年12月澄迈县人民医院重症医学科及呼吸科收治的32例AE-COPD伴呼吸衰竭患者,在常规药物治疗及氧疗基础上应用NPPV治疗,通过自身对照观察患者NPPV治疗前、后血气指标变化和病情改善程度。[结果]32例患者中1例不能耐受无创通气放弃治疗;29例使用无创通气治疗后好转,病情稳定出院;2例无创通气失败,改行气管插管。NPPV治疗有效的患者2h后血气指标明显改善。PaCO,显著下降(P﹤0.05);72h后,病情明显好转。[结论]NPPV对AECOPD合并呼吸衰竭的患者具有良好的治疗作用,其优点是纠正缺氧,改善二氧化碳潴留,值得在临床推广和应用。
[Objective] To analyze the clinical efficacy of noninvasive positive pressure ventilation (NPPV) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and respiratory failure. [Methods] Thirty-two patients with AE-COPD and respiratory failure admitted to the Department of Critical Care Medicine and Respiratory Department of Chengmai People’s Hospital from June 2009 to December 2010 were retrospectively analyzed. NPPV was given on the basis of conventional medical therapy and oxygen therapy , Through their own control NPPV observation before and after treatment of patients with changes in blood gas and disease improvement. [Results] One of 32 patients could not tolerate noninvasive ventilation to give up treatment; 29 patients improved after noninvasive ventilation treatment and were stable discharged; 2 patients failed noninvasive ventilation and changed to tracheal intubation. The blood gas index of patients treated with NPPV was significantly improved after 2 hours. PaCO, significantly decreased (P <0.05); 72h, the condition improved significantly. [Conclusion] NPPV has a good therapeutic effect on patients with AECOPD complicated with respiratory failure, and its advantages are to correct hypoxia and improve carbon dioxide retention, which is worthy of clinical application and promotion.