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目的探讨NPPV(无创正压通气)治疗慢性阻塞性肺疾病(COPD)急性加重期合并呼吸衰竭的治疗作用。方法将2002-12～2004-04大连医科大学附属第一医院呼吸内科住院的COPD急性加重期合并急性呼吸衰竭的患者42例随机分为标准治疗组21例(常规抗感染、支气管扩张剂、祛痰药、激素、氧疗、纠正酸碱失衡的治疗)和NPPV治疗组21例(标准治疗的治疗基础上,采用美国伟康公司经鼻(面)罩双水平气道正压BiPAPVERSION型呼吸机进行辅助通气)。观察患者PaO2、PaCO2变化,比较插管率、病死率、住院时间、住院费用。结果治疗2h后,NPPV治疗组和标准治疗组PaO2、PaCO2、呼吸频率均有明显改善,并且NPPV治疗组明显优于标准治疗组(P<0.05)。NPPV治疗组插管率、病死率、住院时间、住院费用较标准治疗组均明显降低(P<0.05)。结论NPPV可加速改善COPD急性加重期合并呼吸衰竭患者的PaO2、PaCO,可明显缩短住院时间及降低住院费用,降低插管率、病死率。
Objective To investigate the therapeutic effect of NPPV (noninvasive positive pressure ventilation) on respiratory failure in acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods From December 2002 to April 2004, 42 patients with acute exacerbation of COPD who were hospitalized in Department of Respiratory Medicine, the First Affiliated Hospital of Dalian Medical University were randomly divided into standard treatment group (n = 21) (routine anti-infective, bronchodilator, Phlegm, Hormone, Oxygen therapy, and correction of acid-base imbalance) and NPPV treatment group (n = 21). On the basis of the standard therapy, BiPAPVERSION ventilator For assisted ventilation). PaO2, PaCO2 changes were observed in patients with comparison intubation rate, mortality, hospital stay, hospitalization costs. Results After 2 hours of treatment, PaO2, PaCO2 and respiratory rate in NPPV group and standard treatment group were significantly improved, and NPPV treatment group was significantly better than the standard treatment group (P <0.05). The intubation rate, mortality, hospital stay and hospitalization cost in NPPV treatment group were significantly lower than those in standard treatment group (P <0.05). Conclusion NPPV can accelerate the PaO 2 and PaCO in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) complicated with respiratory failure, which can shorten the length of hospital stay, reduce the cost of hospitalization, and reduce the rate of intubation and mortality.