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目的 研究慢性阻塞性肺疾病 (COPD)患者合并肺性脑病时进行无创双水平正压通气 (BiPAP)的效果。方法 6 4例COPD合并肺性脑病患者分为BiPAP组和气管插管机械通气 (ETI-MV)组 ,观察两组的治疗效果。结果 两组患者在存活率方面无显著差异 ;与BiPAP组比较 ,ETI-MV组在治疗 4小时后 ,呼吸衰竭得以纠正 ,但住院期间的严重并发症却明显增多 ,住院时间也明显延长。结论 对于COPD合并肺性脑病患者 ,如果自主呼吸尚可 ,能够耐受BiPAP治疗 ,应先试用Bi PAP ,不要急于应用ETI-MV。
Objective To investigate the effect of noninvasive bi-level positive pressure ventilation (BiPAP) in patients with chronic obstructive pulmonary disease (COPD) complicated with pulmonary encephalopathy. Methods Sixty-four COPD patients with pulmonary encephalopathy were divided into two groups: BiPAP group and ETI-MV group. The therapeutic effects were observed in both groups. Results There was no significant difference in survival rate between the two groups. Compared with BiPAP group, respiratory failure was corrected 4 hours after treatment in ETI-MV group, but the serious complications during hospitalization were significantly increased and the hospitalization time was significantly prolonged. Conclusion In patients with COPD and pulmonary encephalopathy, BiPAP should be used if spontaneous respiration is acceptable and Bi PAP should be used in trial. Do not rush to apply ETI-MV.