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目的探讨双水平气道正压通气(BiPAP)治疗慢性阻塞性肺疾病(COPD)并急性呼吸衰竭的临床效果。方法选取2014年5月—2015年5月成都大学附属医院收治的COPD并急性呼吸衰竭患者60例,根据治疗方法分为对照组和观察组,每组30例。对照组患者采用常规治疗,观察组患者在常规治疗基础上采用BiPAP治疗。比较两组患者治疗后症状/体征改善情况及治疗前后肺功能指标。结果观察组患者治疗后呼吸困难问卷调查评定量表(mMRC)评分、辅助呼吸肌动用评分低于对照组,症状改善时间短于对照组(P<0.05)。治疗前两组患者用力肺活量(FVC)、第1秒用力呼气容积(FEV_1)、第1秒用力呼气容积占预计值百分比(FEV_1%)、FEV_1/FVC比较,差异无统计学意义(P>0.05);治疗后观察组患者FVC、FEV_1、FEV_1%、FEV_1/FVC高于对照组(P<0.05)。结论Bi PAP治疗COPD并急性呼吸衰竭的临床效果确切,可有效改善患者肺功能。
Objective To investigate the clinical effect of bi-level positive airway pressure (BiPAP) in the treatment of chronic obstructive pulmonary disease (COPD) and acute respiratory failure. Methods Sixty patients with COPD and acute respiratory failure admitted to the Affiliated Hospital of Chengdu University from May 2014 to May 2015 were divided into control group and observation group according to the method of treatment, 30 cases in each group. Patients in the control group were treated with conventional therapy, and patients in the observation group were treated with BiPAP on the basis of conventional treatment. The improvement of symptoms and signs after treatment and the indexes of pulmonary function before and after treatment were compared between the two groups. Results The score of mMRC and the score of assistant respiratory muscle in observation group were lower than those in control group after treatment, and the symptom improvement time was shorter than that of control group (P <0.05). Before treatment, forced vital capacity (FVC), FEV 1, FEV 1%, and FEV 1 / FVC were not significantly different between the two groups before treatment (P > 0.05). After treatment, FVC, FEV_1, FEV_1% and FEV_1 / FVC in the observation group were higher than those in the control group (P <0.05). Conclusions Bi PAP is effective in treating COPD with acute respiratory failure and can effectively improve pulmonary function.