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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型呼吸衰竭的治疗作用。方法 2005年10月-2009年10月对COPD合并Ⅱ型呼吸衰竭患者40例,随机分为对照组和治疗组(各20例)。在行常规抗感染、对症治疗的同时,分别予以持续静脉滴注尼可刹米或无创正压通气治疗6h,比较两组治疗前后生命体征及血气分析变化。结果治疗6h后,治疗组在收缩压、呼吸频率及心率方面改善均显著优于对照组(P<0.05)。pH值对照组无改善,治疗组显著改善,两组比较有统计学意义(P<0.05)。治疗后治疗组动脉血氧分压由(51.2±3.7)mmHg上升至(82.3±5.7)mmHg,对照组由(51.4±4.6)mmHg上升至(66.7±8.3)mmHg,治疗组动脉血二氧化碳分压由(78.9±10.0)mmHg降低至(46.9±7.2)mmHg,对照组由(78.6±6.5)mmHg降低至(61.2±5.7)mmHg,治疗组改善明显(P<0.01)。结论无创正压通气治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭效果明显。
Objective To investigate the therapeutic effect of noninvasive positive pressure ventilation on type 2 respiratory failure in patients with chronic obstructive pulmonary disease (COPD). Methods From October 2005 to October 2009, 40 patients with COPD and type Ⅱ respiratory failure were randomly divided into control group and treatment group (20 cases each). Routine anti-infective, symptomatic treatment at the same time, were given continuous intravenous infusion of Nicorandir or noninvasive positive pressure ventilation for 6h, before and after treatment compared vital signs and blood gas analysis changes. Results After 6 hours of treatment, the improvement of systolic blood pressure, respiratory rate and heart rate in the treatment group were significantly better than those in the control group (P <0.05). The pH value of the control group did not improve, the treatment group significantly improved, the two groups were statistically significant (P <0.05). After treatment, the partial pressure of arterial oxygen in treatment group increased from (51.2 ± 3.7) mmHg to (82.3 ± 5.7) mmHg in treatment group and (51.4 ± 4.6) mmHg in control group to (66.7 ± 8.3) mmHg, and the arterial partial pressure of carbon dioxide (78.9 ± 10.0) mmHg to (46.9 ± 7.2) mmHg, while the control group decreased from (78.6 ± 6.5) mmHg to (61.2 ± 5.7) mmHg. The treatment group improved significantly (P <0.01). Conclusion Noninvasive positive pressure ventilation is effective in treating chronic obstructive pulmonary disease with type Ⅱ respiratory failure.