无创正压通气在慢性阻塞性肺疾病急性加重合并Ⅱ型呼吸衰竭中应用价值分析.doc

无创正压通气在慢性阻塞性肺疾病急性加重合并Ⅱ型呼吸衰竭中应用价值分析 　　[摘要] 目的 探讨无创正压通气治疗慢性阻塞性肺疾病急性加重（AECOPD）合并Ⅱ型呼吸衰竭的效果。 方法 选取2012年7月～2014年6月本院收治的57例AECOPD合并Ⅱ型呼吸衰竭患者作为研究对象，按照随机数字表法分成对照组（28例）和观察组（29例）。对照组给予常规治疗及布地奈德福莫特罗粉吸入剂吸入，观察组在对照组的基础上给予无创正压通气治疗。比较两组的通气、氧合、心率、呼吸频率等改善情况。 结果 观察组治疗2、72 h后的心率、呼吸频率、PaCO2水平显著低于治疗前及对照组同时间段，pH值、PaO2水平显著高于治疗前及对照组同时间段，差异有统计学意义（P0.05）。观察组的出院率显著高于对照组，插管率、病死率显著低于对照组，住院时间显著短于对照组，差异有统计学意义（P0.05）。 结论 无创正压通气治疗AECOPD合并Ⅱ型呼吸衰竭效果显著，可有效缓解临床症状，改善患者预后，安全有效。 　　[关键词] 慢性阻塞性肺疾病；Ⅱ型呼吸衰竭；无创正压通气 　　[中图分类号] R563.8 [文献标识码] A [文章编号] 1674-4721（2015）07（c）-0038-03 　　Application value analysis of non-invasive positive pressure ventilation in acute cxacerbation of chronic obstructive pulmonary disease complicated with type Ⅱ respiratory failure 　　CHEN Ming-hui 　　Department of Internal Medicine，People′s Hospital of Guangming New District in Shenzhen City，Shenzhen 518106，China 　　[Abstract] Objective To explore the curative effect of non-invasive positive pressure ventilation in the treatment of acute exacerbation of chronic obstructive pulmonary disease （AECOPD） complicated with Type Ⅱ respiratory failure. Methods 57 patients with AECOPD complicated with type Ⅱ respiratory failure from July 2012 to June 2014 in our hospital were selected and divided into the control group （28 cases） and the observation group （29 cases） according to the method of random number table.The control group was given regular treatment plus inhalant of budesonide and formoterol powder.The observation group was given non-invasive positive pressure on the basis of the control group.Improvement conditions of ventilation，oxygenation，heart rate and breathing frequency in two groups was compared. Results The heart rate and breathing frequency，the level of PaCO2 in the observation group after treatment at 2，72 hours was lower than that before treatment and in the control group at the same time，the value of pH and the level of PaO2 in the observation group after treatment at 2，72 hours was higher than that before treatment and in t