无创正压通气治疗慢性阻塞性肺疾病急性加重期伴Ⅱ型呼吸衰竭.docVIP

无创正压通气治疗慢性阻塞性肺疾病急性加重期伴Ⅱ型呼吸衰竭 　　作者：杨华,周志才,奚峰,周伟菊,吴浩,唐志君　　作者单位：浦东新区人民医院 呼吸内科,上海 　　【摘要】目的:探讨无创正压通气(NIPPV)治疗慢性阻塞性肺疾病(COPD)急性加重期伴Ⅱ型呼吸衰竭患者的疗效观察,并分析患者医疗费用。方法：选择我院2006年至2008年收治的COPD急性加重期伴有Ⅱ型呼吸衰竭患者127例,分为两组:治疗组65例,以无创正压通气加药物治疗;对照组62例，以药物治疗为主。观察两组治疗前后的呼吸频率、心率、肺部啰音和动脉血气等指标。比较两组患者的平均住院天数、住院费、检查费、药费、无创呼吸机通气费、总住院费用等。结果：两组患者在治疗前后其呼吸频率、心率、肺部啰音、血气分析指标均有所改善,治疗组改善更明显,两组比较差异有统计学意义(P0.05)。治疗组的平均住院天数(16.1 d)较对照组(22.3 d)短,治疗组的住院费、检查费、药费、总住院费用均较对照组低,两组比较差异有统计学意义(P0.05)。结论：无创正压通气治疗COPD急性加重期合并呼吸衰竭疗效确切,同时可缩短患者住院天数,降低其住院费用。 　　【关键词】 慢性阻塞性肺疾病,呼吸衰竭,无创正压通气 　　[Abstract] Objective: To analyse the effects and costs of NIPPV in treating patients with acute exacerbation of chronic obstructive pulmonary diseases(COPD) complicated with type Ⅱ respiratory failure. Methods： 127 cases of COPD in acute exacerbation with type Ⅱ respiratory falure were divided into two groups, 62 cases in the contorl group and 65 cases in the study group were treated with drug and drug+NIPPV(noinvasive positive pressure ventilation) respectively. Analysis was made on parameters such as respiratory rate, heart rate and crackles of the lung before and after treatment. The arterial blood gas values before and after the treatment were compared. The average hospital stay and costs were compared between the two groups. Results： The heart rate, respiratory rate and arterial blood gas values in the treatment group were significantly more improved than those in the control group. The treatment group had shorter average hospital stay than the control group. Further more, the cost of hospitalization in the treatment group was remarkably less than that in the control group(P0.05). Conclusion： This study suggests that NIPPV treatment is effective in the treatment of COPD in acute exacerbation with type Ⅱ respiratory failure. It can also reduce hospital stay and average cost. 　　[Key words] chornic obstructive pulmonary disease; respiratory failure; noinvasive positivepressure ventilation 　　慢性阻塞性肺疾病(COPD)诊治过程中,如何有效减少C