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目的探讨双水平无创BIPAP呼吸机对COPD合并Ⅱ型呼衰的治疗效果。方法 38例COPD合并Ⅱ型呼衰患者随机分二组,治疗组和对照组,后者给予常规抗感染、平喘、祛痰等对症治疗和持续低流量给氧,治疗组除常规治疗外加BIPAP无创通气,采用口鼻面罩通气,S/T模式,逐渐调高吸气压力(IPAP)呼气压力(EPAP)到适当水平,氧浓度37%,保持SPO_290%以上通气时间1周,每天2次,每次3h。结果治疗组治疗后ABG中PH值和PaO_2逐渐上升,PaCO_2值下降明显,临床症状改善,呼吸频率,心率均减慢,呼吸困难好转。结论本方法治疗COPD合并Ⅱ型呼衰的治疗效果明显,减少气管插管或气管切开所带来的并发症可能。
Objective To investigate the therapeutic effect of two-level noninvasive BIPAP ventilator on COPD with type Ⅱ respiratory failure. Methods Thirty-eight COPD patients with type Ⅱ respiratory failure were randomly divided into two groups: the treatment group and the control group. The latter were given conventional anti-infective, antiasthmatic and expectorant symptomatic treatment and continuous low-flow oxygen therapy. In addition to conventional treatment plus BIPAP Noninvasive ventilation with nasal mask ventilation, S / T mode, gradually increasing EPAP pressure to an appropriate level, 37% oxygen concentration, maintaining SPO_290% ventilation for 1 week, 2 times a day , Each 3h. Results After treatment, PH and PaO_2 in ABG gradually increased, PaCO_2 decreased significantly, clinical symptoms improved, respiratory rate and heart rate decreased, and dyspnea improved. Conclusion The treatment of COPD with type Ⅱ respiratory failure significantly reduced the effect of reducing tracheal intubation or tracheostomy complications may be.