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目的 研究无创正压通气(NIPPV)治疗慢性阻塞性肺病急性加重期并发Ⅱ型呼吸衰竭的临床效果。方法 1999-01~2004-06深圳铁路医院呼吸内科观察23例NIPPV治疗慢性阻塞性肺病(COPD)急性加重期并发Ⅱ型呼吸衰竭患者的血气指标变化(pH值,PaO2,PaCO2 ),住院病程,气管插管率和病死率,并同以往未使用NIPPV治疗的25例COPD相似病例进行比较分析。结果 23例NIPPV治疗前后24h血气指标明显改善,住院病程缩短,气管插管率和住院病死率明显降低,同非NIPPV治疗的对照组比较差异有显著性。NIPPV组中,重度呼吸衰竭的气管插管率明显高于轻中度呼吸衰竭(P<0 .05 )。结论 NIPPV是治疗慢性阻塞性肺病急性加重期并发Ⅱ型呼吸衰竭的一种有效方法,早期应用可能阻止病情进一步发展,缩短病程。
Objective To study the clinical effect of noninvasive positive pressure ventilation (NIPPV) on type Ⅱ respiratory failure in acute exacerbation of chronic obstructive pulmonary disease. Methods From January 1999 to June 2004, the respiratory medicine of 23 patients with NIPPV in the treatment of acute exacerbation of chronic obstructive pulmonary disease (COPD) complicated with type Ⅱ respiratory failure (pH, PaO2, PaCO2) Tracheal intubation and mortality, and compared with 25 cases of similar COPD that were not treated with NIPPV in the past. Results The blood gas indexes of 23 patients with NIPPV were significantly improved 24 hours after treatment, and the duration of hospitalization was shortened. The rates of tracheal intubation and hospital mortality were significantly lower than those of non-NIPPV-treated control group. In the NIPPV group, intubation rates for severe respiratory failure were significantly higher than those for mild to moderate respiratory failure (P <0.05). Conclusion NIPPV is an effective method for the treatment of type Ⅱ respiratory failure in patients with acute exacerbation of chronic obstructive pulmonary disease. Early application may prevent the further development of the disease and shorten the course of the disease.