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目的 :比较有创与无创性机械通气治疗COPD所致慢性呼吸衰竭的治疗效果。方法 :对比有创与无创性机械通气 48小时后血气三项指标变化及机械通气时间与PH、PaO2 、PaCO2 的相关性和并发症。结果 :有创组机械通气时间为 2 2 85天 ,而无创组则为 8 9天 (P <0 .0 0 1) ,且前者与PaCO2 呈正相关关系 (P <0 .0 5 )。有创组治疗 48小时后 ,PaCO2 下降幅度明显高于无创组 (P <0 .0 5 ) ,意识障碍恢复也较无创组早 (P <0 .0 5 )。有创组的并发症多较严重。结论 :有创通气治疗更有助于CO2 排出 ,使病人及早清醒 ,适合于严重Ⅱ型呼衰者。而无创通气能较早撤机 ,更适合于慢性Ⅰ型呼衰及CO2 潴留不重者。对COPD所致慢性呼衰若保守治疗无效应及早行无创性机械通气 ;对CO2 潴留较重者 ,应及时行有创性机械通气
OBJECTIVE: To compare the efficacy of invasive and noninvasive mechanical ventilation in the treatment of chronic respiratory failure due to COPD. Methods: The changes of three indexes of blood gas after 48 hours of invasive and noninvasive mechanical ventilation were compared, and the correlation between mechanical ventilation time and PH, PaO2, PaCO2 and complications were compared. Results: The duration of mechanical ventilation in the invasive group was 2285 days compared with 89 days in the noninvasive group (P <0.001), and the former was positively correlated with PaCO2 (P <0.05). After 48 hours of treatment, the decrease of PaCO2 was significantly higher in non-invasive group than in non-invasive group (P <0.05). The recovery of disturbance of consciousness was also earlier than non-invasive group (P <0.05). The invasive group of complications are more serious. Conclusion: Invasive ventilation is more conducive to CO2 emissions, the patient awake early, suitable for severe type Ⅱ respiratory failure. Noninvasive ventilation can be weaned earlier, more suitable for chronic type I respiratory failure and CO2 retention is not heavy. Chronic respiratory failure caused by COPD if no conservative treatment of non-invasive mechanical ventilation as early as possible; for those with severe retention of CO2 should be promptly invasive mechanical ventilation