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目的探讨双水平无创正压通气在治疗慢性阻塞性肺疾病(COPD)急性加重期合并Ⅱ型呼吸衰竭中的临床应用价值。方法选择78例COPD急性加重并合并II型呼吸衰竭的患者,分为对照组和无创呼吸机治疗组,两组患者均给予常规治疗;无创呼吸机治疗组在上述常规治疗基础上加双水平无创呼吸机治疗。观察两组治疗患者的动脉血气指标变化,心率改变等。比较24 h后两组患者血气、气管插管率的差异。结果治疗24 h后,与对照组相比,治疗组患者氧分压上升和二氧化碳分压下降均有统计学意义(P<0.05),治疗组的气管插管率小于对照组。结论双水平无创正压通气对COPD急性加重并严重呼吸衰竭疗效显著,改善患者的血气分析,避免气管插管,减少院内感染及抗生素的应用。
Objective To investigate the clinical value of double-level noninvasive positive pressure ventilation in the treatment of acute exacerbation of chronic obstructive pulmonary disease (COPD) complicated with type Ⅱ respiratory failure. Methods A total of 78 patients with acute exacerbation of COPD and type II respiratory failure were divided into control group and non-invasive ventilator-treated group. Both groups were given routine treatment. Non-invasive ventilator-treated group was given double-level non-invasive Ventilator treatment. The changes of arterial blood gas index and heart rate in the two groups were observed. The differences of blood gas and tracheal intubation rate between two groups were compared after 24 hours. Results Compared with the control group, the oxygen partial pressure and the partial pressure of carbon dioxide in the treatment group decreased significantly (P <0.05) 24 h after treatment, and the intubation rate in the treatment group was smaller than that in the control group. Conclusions Dual-level noninvasive positive pressure ventilation has significant curative effect on acute exacerbation of COPD and severe respiratory failure, and improves blood gas analysis, avoids tracheal intubation, and reduces nosocomial infections and antibiotic use.