双水平气道内正压通气治疗慢性阻塞性肺疾病急性发作并Ⅱ型呼吸衰竭的临床疗效观察

摘要目的：观察双水平气道正压通气（bilevelpositiveairwaypressure，BiPAP）呼吸机治疗慢性阻塞性肺疾病急性加重期（acuteex—acerlationofchronicobstructivepulmonarydisease，AECOPD）合并Ⅱ型呼吸衰竭的临床疗效。方法：148例经诊断为AEc0PD合并II型呼吸衰竭的患者，按照入院的先后顺序随机分为对照组及治疗组，每组74例；对照组患者给予抗感染、祛痰、平喘、吸氧等常规治疗；治疗组在上述治疗的基础上，给予BiPAP呼吸机治疗，8h／天，分析治疗前两组患者的基线资料及生命体征，抽取治疗前及治疗后24h、72h股动脉血液进行动脉血气分析（包括pH、PaCO2、PaO2、Sa02等），并比较两组患者的住院天数。结果：治疗前两组患者的基线资料及生命体征指标无显著性差异（P〉0．05）；两组患者治疗后pH、PaCO2、PaO2、SaO2均较治疗前有所改善（P〈0．05或P〈0．01）；与对照组比较，治疗组pH、P02、PC02、Sa02的改善情况显著优于对照组（P〈0．05），且患者的住院天数显著缩短（P〈0．05）。结论：采用BiPAP呼吸机辅助治疗AECOPD合并II型呼衰的患者疗效较常规治疗更好，安全可靠，值得临床推广应用。

The Clinical efficacy of BiPAP Machine in the Treatment of AECOPD with Type Ⅱ Respiratory Failure

Objective： To explore the clinical curative effects of Bi-level Positive Airway Pressure （BiPAP） machine breathing in t- he treatment of acute exacerbation of chronic obstructive pulmonary disease acute exacerbation （AECOPD） with type Ⅱ respiratory failu- re. Methods： 148 patients which were diagnosed as AECOPD with typeⅡ respiratory failure were randomly divided into two groups, the control group and treatment group, there were 74 patients in each group. The control group was treated with antibiotic, eliminate sputum, smoothing asthma and oxygen; based on the treatment of control group, the treatment group was treated with BiPAP machine, 8 h/day. The base line information were analyzed before treatment. Before and 24 hours, 72 hours after treatment, the blood gas analysis（included pH value, PaCO2, PaO2, SaO2）, and hospitalization days of both groups were also analyzed after treatment. Results： No significant difference of the baseline information between the two groups was found （P〉0.05）. After treatment, the blood gas indexes （pH value, PaCO2, PaO2, SaO2） of two groups both improved significantly （P〈0.01）. Compared with the control group, the blood gas indexes improved much more evidently （P〈0.01）, the hospital stay was much shorter （P〈0.01）. Conclusion： Auxiliary treatment with BiPAP breathing machine was more effective to the AECOPD with type Ⅱ respiratory failure patients. Which was worth being popularized in clinic.