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目的:了解BiPAP呼吸机对治疗慢性阻塞性肺疾病(chronic obstructive pulmonary diseases,COPD)合并Ⅱ型呼吸衰竭患者的疗效。方法:62例COPD合并轻、中度Ⅱ型呼吸衰竭(pH7.25～7.35)的住院患者随机被分为治疗组(30例)和对照组(32例),治疗组在常规治疗的基础上连续使用BiPAP呼吸机3d(2次/d,4h/次),对照组仅给以常规治疗。观察两组患者治疗前后血气分析、呼吸频率、心率、Borg评分、肺功能变化以及气管插管率和住院天数。结果:治疗3d后,治疗组pH和PaCO2的改善较对照组更明显(P<0.05)。治疗组气管插管率明显低于对照组(P<0.05);pH7.31～7.35患者中治疗组气管插管率与对照组类似(P>0.05),pH7.25～7.30患者中治疗组气管插管率明显低于对照组(P<0.01)。治疗组住院天数少于对照组(P<0.05)。结论:BiPAP呼吸机能更好地改善COPD合并轻、中度Ⅱ型呼吸衰竭患者的pH和PaCO2,尤其降低中度呼吸衰竭患者气管插管率,缩短住院时间。
Objective: To understand the effect of BiPAP ventilator on patients with chronic obstructive pulmonary diseases (COPD) and type Ⅱ respiratory failure. Methods: Sixty-two inpatients with COPD with mild to moderate respiratory failure (pH7.25-7.35) were randomly divided into treatment group (n = 30) and control group (n = 32). On the basis of routine treatment Continuous use of BiPAP ventilator 3d (2 times / d, 4h / times), the control group was given only conventional treatment. Blood gas analysis, respiratory rate, heart rate, Borg score, changes of pulmonary function, tracheal intubation rate and hospital stay were observed before and after treatment. Results: After 3d, the improvement of pH and PaCO2 in treatment group was more obvious than that in control group (P <0.05). The rate of tracheal intubation in the treatment group was significantly lower than that in the control group (P <0.05). The rate of endotracheal intubation in the treatment group was similar to that in the control group (P> 0.05) at pH 7.31-7.35. The intubation rate was significantly lower than that of the control group (P <0.01). The days of hospitalization in the treatment group were less than those in the control group (P <0.05). CONCLUSIONS: BiPAP ventilator can improve the pH and PaCO2 of patients with COPD complicated with mild and moderate respiratory failure, especially reduce the rate of tracheal intubation in patients with moderate respiratory failure and shorten the hospital stay.