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目的:通过对无创正压通气(NIPPV)治疗非慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭与慢性阻塞性肺疾病急性加重(AECOPD)合并Ⅱ型呼吸衰竭患者的对比分析,了解NIPPV对非慢性阻塞性肺疾病所致Ⅱ型呼吸衰竭的治疗作用,评价NIPPV在治疗非慢性阻塞性肺疾病所致Ⅱ型呼吸衰竭中的治疗价值。方法:对比分析NIPPV对非慢性阻塞性肺疾病与AECOPD所致Ⅱ型呼吸衰竭的治疗效应。非慢性阻塞性肺疾病组18例,男12例,女6例,年龄(63.8±12.5)岁,其中职业性肺疾病10例(尘肺8例,石棉肺2例),脊柱后凸畸形或严重胸膜肥厚粘连5例,支气管扩张3例;AECOPD组33例,男26例,女7例,年龄(69.0±8.5)岁。结果:与NIPPV治疗前比较,非慢性阻塞性肺疾病组应用NIPPV治疗后第5天和出院前动脉血二氧化碳分压(PaCO2)显著下降(P<0.05);pH值在出院前显著改善(P<0.05);动脉血氧分压(PaO2)在应用NIPPV治疗后及出院时各时间点均显著升高(P<0.05)。在AECOPD组同NIPPV治疗前比,应用NIPPV治疗后各时间点和出院前PaCO2均显著下降(P<0.05),pH值显著改善(P<0.05);同NIPPV治疗前比,应用NIPPV治疗第2天、第3天、第5天和出院前PaO2显著升高(P<0.05)。结论:NIPPV对非慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭和AECOPD合并Ⅱ型呼吸衰竭均有较好的治疗效果。NIPPV治疗AECOPD所致Ⅱ型呼吸衰竭与非慢性阻塞性肺疾病相比,pH值和二氧化碳潴留改善得更快,而氧合在非慢性阻塞性肺疾病组改善得更快。NIPPV可用于非慢性阻塞性肺疾病所致Ⅱ型呼吸衰竭的抢救治疗。
OBJECTIVE: To compare and analyze the relationship between non-invasive positive pressure ventilation (NIPPV) and non-chronic obstructive pulmonary disease (COPD) complicated with type Ⅱ respiratory failure and acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and type Ⅱ respiratory failure To evaluate the therapeutic value of NIPPV in the treatment of type Ⅱ respiratory failure caused by non-chronic obstructive pulmonary disease (COPD). Methods: The therapeutic effects of NIPPV on type Ⅱ respiratory failure caused by non-chronic obstructive pulmonary disease and AECOPD were compared and analyzed. There were 18 cases of non-COPD patients, including 12 males and 6 females, with an average age of 63.8 ± 12.5 years. Among them, 10 cases of occupational pulmonary diseases (8 cases of pneumoconiosis and 2 cases of asbestosis), kyphosis or severe Pleural thickening adhesions in 5 cases, 3 cases of bronchiectasis; 33 cases of AECOPD group, 26 males and 7 females, aged (69.0 ± 8.5) years. Results: Compared with pre-treatment NIPPV, the PaCO2 decreased significantly (P <0.05) on the 5th day after NIPPV treatment and before discharge in non-COPD patients. The P value was significantly improved before discharge (P <0.05). PaO2 was significantly increased at all time points after NIPPV treatment and at discharge (P <0.05). Compared with NIPPV before treatment in AECOPD group, NCO treatment significantly decreased (P <0.05) and pH value significantly (P <0.05) at all time points after treatment with NIPPV and before discharge; Day, day 3, day 5 and PaO2 before discharge were significantly increased (P <0.05). Conclusion: NIPPV has a good therapeutic effect on non-COPD patients with type Ⅱ respiratory failure and AECOPD with type Ⅱ respiratory failure. NIPPV treatment AECOPD induced type 2 respiratory failure Compared with non-chronic obstructive pulmonary disease, pH and carbon dioxide retention improved faster, and oxygenation in non-chronic obstructive pulmonary disease group improved more rapidly. NIPPV can be used for non-chronic obstructive pulmonary disease Respiratory failure Rescue Treatment.