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目的探讨双水平无创气道正压通气(BiPAP)对慢性阻塞性肺病急性发作(AECOPD)合并Ⅱ型呼吸衰竭的临床治疗效果。方法将40例中、重度AECOPD合并Ⅱ型呼吸衰竭住院患者随机分为两组各20例。治疗组在常规抗感染,解痉,平喘吸氧等治疗的基础上进行BiPAP呼吸机无创通气治疗。在通气4h、48h和治疗结束时作血气分析,比较治疗组pH、PaO2、PaCO2值的变化,观察临床症状改善情况,气管插管率,并与对照组比较。结果通气后4h、48h,结束时pH值和PaO2逐渐上升,PaCO2逐渐下降,气管插管率下降,临床症状改善。对照组疗效不明显。结论无创正压通气治疗AECOPD合并Ⅱ型呼吸衰竭临床效果显著。
Objective To investigate the clinical effect of bi-level noninvasive positive airway pressure (BiPAP) on patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and type Ⅱ respiratory failure. Methods Forty patients with moderate and severe AECOPD and type Ⅱ respiratory failure were randomly divided into two groups of 20 cases each. The treatment group in the conventional anti-infective, antispasmodic, asthma and oxygen therapy based on the BiPAP ventilator non-invasive ventilation treatment. Blood gases were analyzed at 4h, 48h after ventilation and at the end of treatment. The changes of pH, PaO2 and PaCO2 in the treatment group were compared. The improvement of clinical symptoms and tracheal intubation rate were observed and compared with the control group. Results After 4h, 48h, the pH and PaO2 gradually increased, PaCO2 decreased gradually, and the rate of tracheal intubation decreased. The clinical symptoms improved. The effect of the control group is not obvious. Conclusion Noninvasive positive pressure ventilation has a significant clinical effect in treating AECOPD complicated with type Ⅱ respiratory failure.