BiPAP治疗对中、重度COPD患者上腹部手术疗效观察.doc

BiPAP治疗对中、重度COPD患者上腹部手术疗效观察[摘要] 目的 探讨围手术期无创双水平正压通气在老年慢性阻塞性肺疾病（COPD）患者上腹部手术的治疗效果。方法 治疗组在常规治疗的基础上加用间歇无创双水平正压通气，对照组围手术期采用常规抗感染、祛痰、止咳、平喘治疗。结果 治疗组各项指标术后第2天开始恢复，术后第5天恢复至术前水平；对照组各项指标术后第2天开始恢复，术后第7天恢复至术前水平。治疗组肺部并发症发生率明显低于对照组，治疗组平均住院天数明显短于对照组（P＜0.05）。结论 中、重度COPD患者围手术期无创双水平正压通气治疗可以有效地改善患者气流受限的程度。 [关键词] 围手术期；无创双水平正压通气；慢性阻塞性肺疾病；疗效 [中图分类号] R563 [文献标识码] B [文章编号] 1673-9701（2011）24-62-03 Effects Observation of Non-invasive Bi-level Positive Airway Pressure Treating in Moderate and Severe Chronic Obstructive Pulmonary Disease JIN Litong1 ZHU Junfei2 HUANG Juxiu1 1.Emergency Department of Taizhou Central Hospital，Tanzhou 318000，China；2. Respiratory Medicine Department of Taizhou Central Hospital，Taizhou 318000，China [Abstract] Objective To discuss the effects of non-invasive bi-level positive airway pressure treating in moderate and severe chronic obstructive pulmonary disease. Methods Control group was treated by traditional methods with anti-inflammatory，expectorant，cough，asthma. Study group was treated by non-invasive bi-level positive airway pressure based on the methods of control group. Results The index in study group was recovered from 2nd day of treatment，and to level before treatment in 5th day. The index in control group was recovered to level before treatment in 7th day. Complications of study group were significantly lower than control group， and the average hospital stay time were significantly less than control group（P＜0.05）. Conclusion It has good effects of non-invasive bi-level positive airway pressure treating in moderate and severe chronic obstructive pulmonary disease. [Key words] Perioperative period；Non-invasive bi-level positive airway pressure；Chronic obstructive pulmonary disease；Effect 上腹部手术由于解剖部位的特点，术后肺部并发症的发生率远高于其他部位的手术[1]，中、重度慢性肺疾病（chronic obstructive pulmonary disease，COPD）患者由于肺功能差，在上腹部手术后更容易产生肺部并发症。如何减少手术后肺部并发症，使其安全地渡过手术，一直是内、外科医师共同的目标。受无创双水平正压通气（bi-level positive airway pressure，BiPAP）在伴有呼吸衰竭的COPD患者急性发作期的治疗上取得的良好疗效[2，3]的影响，我们试对