无创正压通气在慢性阻塞性肺疾病伴呼吸衰竭患者中的治疗效果

陈宁

[摘要]目的 探讨无创正压通气治疗慢性阻塞性肺疾病伴呼吸衰竭的临床效果。方法 于2015年1月～2016年6月，选取我院急诊科收治的100例慢性阻塞性肺疾病伴呼吸衰竭患者，采用随机数字表法将其分为对照组、观察组，每组50例。对照组实施常规对症治疗，观察组在常规对症治疗的基础上加以无创正压通气治疗。比较两组患者治疗前后的氧分压（PaO2）、二氧化碳分压（PaCO2）、pH值、呼吸频率（RR），比较两组患者的死亡情况。结果 治疗后，两组患者的PaO2、PaCO2、pH值、RR较治疗前均明显改善（P<0.01），且观察组与对照组比较差异有统计学意义（P<0.01）；观察组患者的死亡率（0%）与对照组（4%）比较，差异无统计学意义（P>0.05）。结论 无创正压通气联合常规对症治疗慢性阻塞性肺疾病伴呼吸衰竭可有效纠正患者的血氧状况，改善预后。

[关键词]慢性阻塞性肺疾病；呼吸衰竭；无创正压通气；急诊

[中图分类号] R563 [文献标识码] A [文章编号] 1674-4721（2016）10（c）-0026-03

[Abstract]Objective To study the clinical effect of noninvasive positive pressure ventilation in the treatment of chronic obstructive pulmonary disease with respiratory failure.Methods From January 2015 to June 2016，100 cases of chronic obstructive pulmonary disease with respiratory failure patients from Emergency Department in our hospital were selected and divided into the control group and the observation group by using the method of random number table，each group had 50 cases.The control group was given routine treatment，and the observation group was treated with noninvasive positive pressure ventilation on the basis of conventional treatment.The oxygen partial pressure （PaO2），carbon dioxide partial pressure （PaCO2），pH index，respiratory rate （RR） before and after the treatment were compared between the two groups，and the death was compared between the two groups.Results After treatment，the PaO2， PaCO2， pH index，and RR between two groups were significantly improved than those before treatment （P<0.01），and there was a significant difference between the control group and the observation group（P<0.01）.The mortality rate of the observation group （0%） was compared with the control group （4%），the difference was not statistically significant （P>0.05）.Conclusion Noninvasive positive pressure ventilation combined with routine treatment can effectively correct the blood oxygen status and improve the prognosis of patients with chronic obstructive pulmonary disease with respiratory failure.

[Key words]Chronic obstructive pulmonary disease；Respiratory failure；Noninvasive positive pressure ventilation；Emergency

慢性阻塞性肺疾病属于临床常见的慢性呼吸道疾病，临床表现以气流不可逆的受限为主，病程相对较长，病情呈进行性发展[1-2]，患者在急性发作期往往会出现严重的呼吸功能受限，易并发呼吸衰竭，病情发展速度较快，易致死，故应对慢性阻塞性肺疾病伴呼吸衰竭患者进行积极有效的治疗，而采取何种治疗方式更为有效还有待临床进一步商榷[3-4]。本次研究共选取100例慢性阻塞性肺疾病伴呼吸衰竭患者进行分组比较，分别实施常规对症治疗、无创正压通气治疗，现将结果报道如下。

1资料与方法

1.1一般资料

选取2015年1月～2016年6月我院急诊科收治的100例慢性阻塞性肺疾病伴呼吸衰竭患者作为研究对象，所有患者均具有慢性阻塞性肺疾病病史，且合并呼吸衰竭，排除肺栓塞、肺癌、支气管扩张、心脑血管疾病、肝肾功能严重不全、严重心律失常、持续昏迷等患者。……