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目的探讨BiPAP辅助通气对慢性阻塞性肺疾病急性发作(AECOPD)合并呼吸衰竭的治疗效果。方法92例AECOPD合并呼吸衰竭患者随机分为两组,治疗组46例在常规治疗基础上,同时给于鼻(面)罩双水平气道正压(BiPAP)通气治疗,对照组46例给予常规治疗及鼻导管给氧,观察治疗前后患者血气分析的pH值、PaO2、PaCO2动态变化并比较两组间的差别。结果治疗后不同时间点2组的比较均有显著性差异(P<0.05);2组患者治疗后血气分析pH、PaO2、PaCO2的动态变化趋势具有显著性差异(P<0.001);治疗5d后,2组患者的Borg呼吸困难分级均明显下降(均P<0.001),但治疗组的Borg呼吸困难分级改善明显好于对照组(P<0.001)。结论BiPAP呼吸机可改变AECOPD合并呼吸衰竭的短期血气变化及短期预后。
Objective To investigate the therapeutic effect of BiPAP assisted ventilation on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) combined with respiratory failure. Methods Ninety-two patients with AECOPD complicated with respiratory failure were randomly divided into two groups. 46 patients in the treatment group were treated with BiPAP ventilation on the basis of routine treatment and 46 patients in the control group were given conventional Treatment and nasal catheter oxygen, before and after treatment in patients with blood gas analysis of the pH, PaO2, PaCO2 dynamic changes and compare the differences between the two groups. Results After treatment, there were significant differences in the changes of pH, PaO2 and PaCO2 between the two groups at different time points (P <0.05). After 5 days of treatment, the dynamic changes of pH, PaO2 and PaCO2 were significantly different (P <0.001). However, the scores of Borg dyspnea in treatment group were significantly better than those in control group (P <0.001). Conclusion BiPAP ventilator can change short-term blood gas changes and short-term prognosis of AECOPD complicated with respiratory failure.