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目的:观察双水平气道正压通气(bi-level positive airway pressure,BiPAP)呼吸机治疗慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)合并II型呼吸衰竭的临床疗效。方法:148例经诊断为AECOPD合并Ⅱ型呼吸衰竭的患者,按照入院的先后顺序随机分为对照组及治疗组,每组74例;对照组患者给予抗感染、祛痰、平喘、吸氧等常规治疗;治疗组在上述治疗的基础上,给予BiPAP呼吸机治疗,8h/天,分析治疗前两组患者的基线资料及生命体征,抽取治疗前及治疗后24h、72h股动脉血液进行动脉血气分析(包括pH、PaCO2、PaO2、SaO2等),并比较两组患者的住院天数。结果:治疗前两组患者的基线资料及生命体征指标无显著性差异(P>0.05);两组患者治疗后pH、PaCO2、PaO2、SaO2均较治疗前有所改善(P<0.05或P<0.01);与对照组比较,治疗组pH、PO2、PCO2、SaO2的改善情况显著优于对照组(P<0.05),且患者的住院天数显著缩短(P<0.05)。结论:采用BiPAP呼吸机辅助治疗AECOPD合并Ⅱ型呼衰的患者疗效较常规治疗更好,安全可靠,值得临床推广应用。
Objective: To observe the clinical efficacy of bi-level positive airway pressure (BiPAP) ventilator in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with type II respiratory failure . Methods: A total of 148 patients diagnosed as AECOPD with type Ⅱ respiratory failure were randomly divided into control group and treatment group according to the order of admission, with 74 patients in each group. The patients in control group were given anti-infective, expectorant, antiasthmatic, And other routine treatment; the treatment group on the basis of the above treatment, given BiPAP ventilator treatment, 8h / day, analysis of baseline data before treatment and two groups of patients with vital signs, extraction of 24h and 72h after treatment of femoral artery blood artery Blood gas analysis (including pH, PaCO2, PaO2, SaO2, etc.), and compared the length of stay in two groups of patients. Results: There was no significant difference in baseline data and vital signs between the two groups before treatment (P> 0.05). After treatment, the values of pH, PaCO2, PaO2 and SaO2 in both groups were significantly improved (P <0.05 or P < 0.01). Compared with the control group, the improvement of pH, PO2, PCO2 and SaO2 in the treatment group was significantly better than that in the control group (P <0.05), and the hospitalization days were significantly shortened (P <0.05). Conclusion: BiPAP ventilator assisted treatment of AECOPD patients with type Ⅱ respiratory failure than the conventional treatment of better efficacy, safe and reliable, it is worthy of clinical application.