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目的探讨使用双水平正压通气治疗COPD合并Ⅱ型呼吸衰竭的临床疗效。方法 60例COPD合并Ⅱ型呼吸衰竭患者随机分成对照组和治疗组,对照组给予持续低浓度氧疗,抗感染、平喘、祛痰、维持水电解质平衡及对症支持治疗,治疗组在对照组治疗基础上使用BiPAP呼吸机行间断双水平正压通气治疗,比较两组患者的临床疗效。结果治疗2h、24h后,治疗组PH、PO2、PCO2、SpO2指标较对照组改善,差异有统计学意义(P<0.05),治疗24h后治疗组心率、呼吸频率较对照组改善,差异有统计学意义(P<0.05),治疗组住ICU时间较对照组减少,差异有统计学意义(P<0.05),两组气管插管率无显著性差异(P>0.05)。结论早期应用双水平气道正压通气治疗可善AECOPD合并Ⅱ型呼吸衰竭患者的血气等临床指标,疗效肯定。
Objective To investigate the clinical effect of double positive airway pressure on COPD with type Ⅱ respiratory failure. Methods Sixty COPD patients with type Ⅱ respiratory failure were randomly divided into control group and treatment group. The control group was given continuous low oxygen therapy, anti-infection, antiasthmatic and expectorant treatment, water-electrolyte balance and symptomatic supportive treatment. The treatment based on the use of BiPAP ventilator intermittent bi-level positive pressure ventilation treatment, the clinical efficacy of two groups were compared. Results After treatment for 2h and 24h, PH, PO2, PCO2 and SpO2 in treatment group were significantly improved compared with those in control group (P <0.05). After treatment for 24 hours, the heart rate and respiratory rate in treatment group were improved as compared with those in control group (P <0.05). The ICU stay in the treatment group was significantly shorter than that in the control group (P <0.05). There was no significant difference in tracheal intubation rate between the two groups (P> 0.05). Conclusions Early application of bilevel positive airway pressure to treat AECOPD complicated with type Ⅱ respiratory failure in patients with blood gas and other clinical indicators, the effect is positive.