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目的采用回顾性方法总结无创正压通气(NPPV)对慢性阻塞性肺疾病急性加重期(AECOPD)并Ⅱ型呼吸衰竭的治疗效果,分析治疗的相关因素。方法对2001年1月至2005年12月广州市番禺区人民医院呼吸内科112例AECOPD并Ⅱ型呼吸衰竭患者在普通病房使用NPPV治疗,并对有效组与无效组进行临床分析。比较两组在NPPV治疗前、治疗1~2h、24h及治疗结束后心率(HR)、呼吸频率(RR)、血气分析的变化。结果有效组NPPV治疗1~2h后PaO2、PaCO2明显改善;24h后氧合指数(OI)、HR、RR、SaO2、PaO2、PaCO2、pH明显改善。无效组治疗1~2h后与治疗前相比PaO2、PaCO2无明显改善,治疗24h后各指标也无改善。结论AE-COPD并Ⅱ型呼吸衰竭可在普通病房应用NPPV救治,治疗1~2h、24h后血气分析、HR、RR明显改善的患者预后较好。
Objective To retrospectively review the therapeutic effect of noninvasive positive pressure ventilation (NPPV) on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and type Ⅱ respiratory failure, and analyze the related factors of treatment. Methods From January 2001 to December 2005, 112 patients with AECOPD and type Ⅱ respiratory failure in Panyu District People’s Hospital of Guangzhou City were treated with NPPV in general ward, and the clinical data of effective and ineffective groups were analyzed. The changes of heart rate (HR), respiratory rate (RR) and blood gas analysis before NPPV treatment were compared between the two groups at 1 ~ 2h, 24h and after treatment. Results PaO2 and PaCO2 were significantly improved after 1 ~ 2 h in NPPV group. The oxygenation index (OI), HR, RR, SaO2, PaO2, PaCO2 and pH were significantly improved after 24h. In the ineffective group, PaO2 and PaCO2 had no significant improvement after 1 ~ 2h compared with that before treatment, and there was no improvement after 24 hours of treatment. Conclusions AE-COPD and type Ⅱ respiratory failure can be treated with NPPV in general ward for 1-2 hours. After 24 hours, blood gas analysis, HR and RR improved obviously.