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目的探讨无创正压通气在慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭中的临床疗效。方法 82例COPD合并Ⅱ型呼吸衰竭患者随机分为对照组和治疗组,每组各41例,在进行内科常规治疗的同时,对照组持续静脉滴注尼可刹米和洛贝林,治疗组应用无创正压通气治疗,比较两组治疗前后血气分析和生命体征变化。结果两组治疗7d后,治疗组有效率显著优于对照组(P<0.01)。两组治疗24h后不同时期内,对照组pH值无改善,而治疗组pH值显著改善,两组比较差异有统计学意义(P<0.05);治疗组和对照组均有动脉血氧分压上升和动脉血二氧化碳分压下降,治疗组改善更明显(P<0.01);治疗组在心率、呼吸频率方面改善均显著优于对照组(P<0.05或P<0.01)。结论无创正压通气治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者,疗效显著,其在改善动脉血气分析指标和临床生命体征方面均优于常规治疗,值得推广应用。
Objective To investigate the clinical effect of noninvasive positive pressure ventilation in chronic obstructive pulmonary disease (COPD) complicated with type Ⅱ respiratory failure. Methods Eighty-two patients with COPD and type Ⅱ respiratory failure were randomly divided into control group and treatment group, 41 cases in each group. In the routine medical treatment, the control group received continuous intravenous infusion of nicotine and lobeline, Noninvasive positive pressure ventilation was used to compare the changes of blood gas and vital signs before and after treatment. Results After 7 days of treatment, the effective rate of the treatment group was significantly better than that of the control group (P <0.01). The pH value of the control group did not improve in the two groups at different time points after 24h, but the pH value of the treatment group was significantly improved (P <0.05). Both the treatment group and the control group had arterial partial pressure of oxygen (P <0.01 or P <0.01). The improvement in heart rate and respiratory rate of the treatment group was significantly better than that of the control group (P <0.05 or P <0.01). Conclusion Noninvasive positive pressure ventilation is effective in patients with chronic obstructive pulmonary disease and type Ⅱ respiratory failure. It is superior to routine therapy in improving arterial blood gas analysis and clinical vital signs, and is worth popularizing and applying.