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目的探讨经鼻面罩双水平气道正压(BiPAP)无创通气呼吸机治疗慢性阻塞性肺病(COPD)急性呼吸衰竭的临床效果。方法将60例确诊为COPD的急性呼吸衰竭患者随机分为两组,实验组(30例)在常规治疗的同时给予BiPAP无创通气;对照组(30例)在常规治疗基础上给予经鼻导管持续吸入氧气。观察两组治疗前、治疗2h和12h后动脉血气分析结果,同时记录呼吸频率、心率、平均血压等指标。结果实验组通气治疗后2h,二氧化碳分压从(54±10)mmHg降至(44±11)mmHg,氧分压从(55±20)mmHg上升至(79±22)mmHg,明显改善(P<0.05);血pH以及呼吸频率、心率、平均血压比治疗前也有明显改善(P<0.05)。治疗后12h,上述各指标进一步改善(P<0.05)。而对照组治疗前后无明显改变(P>0.05)。治疗后2h和12h,实验组各指标与对照组比较,差异有统计学意义(P<0.05)。结论BiPAP无创通气对提高COPD急性呼吸衰竭患者动脉血氧分压、降低二氧化碳分压及改善呼吸衰竭的效果肯定。
Objective To investigate the clinical effect of nasal mask BiPAP noninvasive ventilator in the treatment of chronic obstructive pulmonary disease (COPD) acute respiratory failure. Methods Sixty patients with acute respiratory failure who were diagnosed as COPD were randomly divided into two groups. The experimental group (n = 30) received BiPAP noninvasive ventilation at the same time. The control group (n = 30) was given nasal cannula on the basis of routine treatment Inhale oxygen. The results of arterial blood gas analysis before treatment, 2h and 12h after treatment were recorded, and the respiratory rate, heart rate and mean blood pressure were recorded. Results After 2 hours of ventilation, the partial pressure of carbon dioxide decreased from (54 ± 10) mmHg to (44 ± 11) mmHg in experimental group, and the partial pressure of oxygen increased from (55 ± 20) mmHg to (79 ± 22) mmHg <0.05). Blood pH, respiratory rate, heart rate and mean blood pressure were also significantly improved before treatment (P <0.05). After 12h treatment, the above indexes were further improved (P <0.05). The control group before and after treatment no significant change (P> 0.05). 2h and 12h after treatment, the experimental group compared with the control group, the difference was statistically significant (P <0.05). Conclusion BiPAP non-invasive ventilation to improve COPD patients with arterial partial pressure of oxygen, reduce carbon dioxide partial pressure and improve the effect of respiratory failure certainly.