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目的:观察双水平无创正压通气(BiPAP)治疗慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭的临床疗效。方法:我院收治COPD合并Ⅱ型呼吸衰竭患者67例,随机分为两组,治疗组44例,对照组23例,治疗组在常规治疗的同时联合BiPAP;对照组给予抗感染、控制性氧疗、应用支气管扩张剂、祛痰剂、糖皮质激素、以及纠正电解质紊乱等对症支持的常规治疗,并行鼻导管持续低流量吸氧。观察两组在治疗前后动脉血pH值、动脉血氧分压(PaO2)、动脉血氧饱和度(SpO2)、动脉血二氧化碳分压(PaCO2)、心率(P)、呼吸频率(R)、住院天数的变化。结果:两组患者治疗前血气分析各项指标动脉血pH值、PaO2、SpO2、PaCO2,经统计学分析,差异无统计学意义(P>0.05);与对照组比较,治疗组通气后PaCO2下降,PaO2、SpO2升高,P减慢,与通气前比较有统计学差异(P<0.05)。结论:BiPAP是治疗COPD合并Ⅱ型呼吸衰竭的有效方法,能够快速缓解患者的临床症状,减少患者的住院时间,降低患者死亡率,值得临床推广和应用。
Objective: To observe the clinical effect of bi-level non-invasive positive pressure ventilation (BiPAP) on chronic obstructive pulmonary disease (COPD) with type Ⅱ respiratory failure. Methods: A total of 67 COPD patients with type Ⅱ respiratory failure were randomly divided into two groups: 44 cases in the treatment group and 23 cases in the control group. The patients in the treatment group were treated with BiPAP in combination with conventional therapy. The control group was given anti-infection and control oxygen Treatment, bronchodilators, expectorants, glucocorticoids, and symptomatic support for correcting electrolyte disturbances were routinely treated, and nasal continuous low oxygen flow was continued. The arterial blood pH, PaO2, SpO2, PaCO2, heart rate (P), respiratory rate (R), hospitalization Changes in the number of days. Results: There was no significant difference in arterial blood pH, PaO2, SpO2 and PaCO2 between the two groups before treatment (P> 0.05). Compared with the control group, PaCO2 decreased , PaO2, SpO2 increased, P slowed down compared with before ventilation (P <0.05). Conclusion: BiPAP is an effective method to treat COPD with type Ⅱ respiratory failure. It can quickly relieve the clinical symptoms, reduce the hospitalization time and reduce the mortality of patients. It is worthy of clinical promotion and application.