无创正压通气治疗慢性阻塞性肺疾病急性加重期合并呼吸衰竭疗效观察.doc

无创正压通气治疗慢性阻塞性肺疾病急性加重期合并呼吸衰竭疗效观察 　　[摘要] 目的 探讨无创正压通气治疗慢性阻塞性肺疾病（COPD）急性加重期合并呼吸衰竭的临床疗效。方法 将本院2010年11月～2011年11月收治入院的COPD患者65例随机分为治疗组（33例）和对照组（32例）。对照组给予临床常规治疗，治疗组在对照组治疗的基础上给予无创正压通气治疗，3次/d，2 h/次，连续5 d。观察两组治疗前后血气分析、呼吸、心率及临床预后。 结果 两组治疗5 d后动脉血氧分压（PaO2）、动脉二氧化碳分压（PaCO2）、呼吸、心率均较治疗前明显好转（P ＜ 0.05）。治疗组治疗后呼吸、心率改善较对照组明显，差异有统计学意义（P ＜ 0.05）；PaO2、PaCO2改善更明显，差异有统计学意义（P ＜ 0.01）。治疗组气管插管率为9.09%（3/33），对照组为28.13%（9/32），两组比较差异有统计学意义（P ＜ 0.05）。两组副作用比较差异无统计学意义（P ＞ 0.05）。 结论 无创正压通气治疗COPD急性加重期合并呼吸衰竭能明显纠正患者血气交换障碍，降低气管插管率，值得临床推广应用。 　　[关键词] 无创正压通气；慢性阻塞性肺疾病；疗效；观察 　　[中图分类号] R56 [文献标识码] A [文章编号] 1674-4721（2012）06（a）-0059-02 　　Observation of the curative effect on non-invasive positive pressure ventilation in the treatment of acute exacerbation of chronic obstructive pulmonary disease combined with respiratory failure 　　SUN Liying 　　Yantai Hospital of Traditional Chinese Medicine in Shandong Province, Yantai 264000, China 　　[Abstract] Objective To discuss the clinical effect of non-invasive positive pressure ventilation in the treatment of acute exacerbation of chronic obstructive pulmonary disease (COPD) combined with respiratory failure. Methods Sixty five cases of patients with acute exacerbation of COPD admitted to our hospital from November 2010 to November 2011 were randomly divided into treatment group (33 cases) and control group (32 cases). The control group was given clinical conventional treatment. On basis of control group, the treatment group was given non-invasive positive pressure ventilation, 3 times a day，2 hours one time, for 5 days. The blood gas analysis, respiration, heart rate and clinical outcomes before and after treatment between the two groups were observed. Results After treatment for 5 days, the PaO2, PaCO2, respiration, heart rate in both groups were improved compared with before treatment, there were statistically significant differences (P ＜ 0.05). After treatment, the respiration and heart rate in the treatment group were better than the control group, the differences w