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目的评价经鼻(面)罩机械通气治疗老年慢性阻塞性肺疾病(COPD)呼吸衰竭的疗效。方法选择COPD急性加重伴Ⅱ型呼吸衰竭的60岁以上老年患者24例,在常规治疗的基础上经鼻(面)罩压力支持+通气呼气末正压(PSV+PEEP)治疗,自主呼吸减弱时改用同步间歇强制通气+压力支持(SIMV+PSV)治疗为机械通气组(治疗组),并以同期病情相当的24例患者仅采用常规治疗作对照组。动态观察两组患者治疗前后动脉血气及病情变化。结果治疗组与对照组治疗前的各项指标相仿P>0.05;治疗组通气治疗前后动脉氧分压(PaO2)及动脉二氧化碳分压(PaCO2)明显改善P<0.01;治疗48h候通气治疗组PaO2及PaCO2明显好于对照组P<0.01;通气治疗组与对照组平均住院时间分别为(15±6)和(22±11)天,P<0.05,通气治疗组平均住院时间明显缩短。结论经鼻(面)罩无创机械通气对老年COPD呼吸衰竭疗效肯定,早期应用可促进疾病康复,缩短住院时间,不失为COPD呼吸衰竭治疗的重要手段。
Objective To evaluate the efficacy of nasal (facial) mask ventilation in the treatment of respiratory failure in elderly patients with chronic obstructive pulmonary disease (COPD). Methods Twenty-four elderly patients over 60 years old with acute exacerbation of COPD and type Ⅱ respiratory failure were selected. On the basis of routine treatment, nasal (face) mask pressure support + positive end-expiratory pressure (PSV + PEEP) The patients were treated with mechanical ventilation (SIMV + PSV) as the mechanical ventilation group (treatment group), and 24 patients with the same period of illness were treated with conventional therapy only. Dynamic observation of arterial blood gas and disease changes in two groups before and after treatment. Results Before treatment, the indexes of treatment group and control group were similar (P> 0.05); PaO2 and PaCO2 of the treatment group before and after ventilation were significantly improved (P <0.01); PaO2 And PaCO2 were significantly better than those in the control group (P <0.01). The average length of hospital stay in the ventilation group was (15 ± 6) days and (22 ± 11) days in the control group, respectively, P <0.05. Conclusion Nasal (facial) mask noninvasive mechanical ventilation for the elderly COPD respiratory failure positive effect, early application can promote disease rehabilitation, shorten the hospital stay, after all, an important means of treatment of COPD respiratory failure.