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本文报道高原低氧寒冷特殊环境下，２０例慢性肺心病Ⅱ型呼衰患者应用呼吸兴奋剂尼可刹米并用面（鼻）罩支持人工通气的临床疗效。慢性肺心病伴ＣＯ＿２潴留时，尼可刹米可兴奋呼吸中枢，提高通气量，呼吸形态变浅速而通气效率改善不够理想，加至慢性肺心病患者气道阻力高、ＰａＣＯ＿２下降趋势缓慢，并用面（鼻）罩无创性人工通气，可克服慢阻肺患者气道阻力高的特点。采用自主呼吸模式（Ｓ模式）、逐渐增大吸气相正压１．５６９～１．９６１ｋＰａ，使患者容易适应和合作，减慢呼吸频率、减慢心率、减轻呼吸肌肉作功。压力支持通气显著的改善了尼可刹米兴奋中枢的浅速呼吸、通气效率差的弊端。补偿了高原慢性肺心病患者保持较高的中枢驱动性和对低氧通气的反应性，以发挥吸氧及药物的积极作用。
This paper reports the clinical efficacy of artificial respiratory ventilation with nostril (nosocomial respiratory stimulant) and facial (nasal) mask in 20 patients with chronic pulmonary heart disease type Ⅱ respiratory failure under the special circumstances of plateau hypoxia and cold. Chronic pulmonary heart disease with CO 2 retention, nikethamide can excite the respiratory center, increased ventilation, shallow breathing pattern of ventilation and improve ventilation efficiency is not ideal, added to chronic pulmonary heart disease patients with high airway resistance, PaCO_2 decline slow, and use Face (nose) cover non-invasive artificial ventilation, can overcome the characteristics of patients with COPD high airway resistance. With spontaneous breathing mode (S mode), gradually increase the suction phase positive pressure 1.569 ~ 1.961kPa, so that patients can easily adapt and cooperate to slow down the respiratory rate, heart rate, reduce respiratory muscle work. Pressure support ventilation significantly improves the shortcomings of Nikkiris excited center of the shallow breathing, poor ventilation efficiency. Compensates for patients with high altitude chronic pulmonary heart disease to maintain a high central drive and reactivity to hypoxic ventilation in order to play a positive role in oxygen and drugs.