应用BiPAP治疗COPD临床疗效观察.docVIP

应用BiPAP治疗COPD临床疗效观察 　 作者：黄新苏， 郑宗茂，韩飞，郑衍平 【关键词】 慢性阻塞性肺疾病 　　摘要：目的：观察无创正压机械通气对慢性阻塞性肺疾病（COPD）的临床治疗效果。方法：在80例COPD患者中随机选择了40例进行规律性无创双水平气道正压机械通气辅助治疗，每日上机两次，每次2h，2周为一疗程。比较上机前、上机2h、24h、1周、2周后动脉血气中pH值，PaO2值，PaCO2值及临床症状变化情况。结果：治疗组治疗2h、24h、1周、2周后动脉血气中pH值和PaO2值逐步上升，PaCO2值逐步下降，临床症状明显改善，有效率为87.5%（35/40）。对照组动脉血气中pH值，PaO2，PaCO2值及临床表现虽有不同程度的改善，但与治疗组同期比较，差异均有显著性（Plt;0.05）。结论：无创双水平气道正压机械通气辅助治疗COPD具有显著的临床治疗效果。 　　关键词：肺疾病，阻塞性/治疗；呼吸；人工 　　Clinical Study of the Noninvasive Mechanical Ventilation for Treatment of 　　Abstract: Objective: To evaluate the clinical efficacy of noninvasive mechanical ventilation for the treatment of patients with chronic obstructive pulmonary disease(COPD). Method: Eighty COPD patients were divided equally at random into two groups(1)mechanical ventilation and(2)no mechanical ventilation (as control). The first groups was treated with double channel noninvasive mechanical ventilator twice a day and 2 hours per time, each course lasted for 2 weeks. Arterial blood pH, PaO2 and PaCO2 were measured and changes of clinical symptoms were recorded in both groups before and 2 hours, 24 hours, 1 week and 2 weeks after treatment, respectively. Result: In first group, arterical Ph and PaO2 elevated gradually, accompany with gradual decline of PaCO2 and prominently clinical symptoms. Its effective rate of treatment was 87.5%（35/40）. As for the control group, three parameters of arterial blood and clinical symptoms were also improved to a certain degree, but significant difference existed as compared with the first group(Plt;0.05).Conclusion: Noninvasive mechanical ventilation as an auxiliary treatment is definitely valuable for COPD patients. 　　Key words: Lung diseases； Obstructive/ TH; Respiration； Artificial 　　国内外文献报道，无创机械通气（BiPAP）治疗慢性阻塞性肺疾病（COPD）有明显的疗效，但由于缺乏成熟的技术及客观明了的使用指导，其临床应用并不广泛。我们将应用该技术治疗COPD，取得了显著的临床疗效，现将结果报道如下。 　　1 对象与方法 　　1.1 对象：选择2001年10月至2005年10月本院呼吸内科收治的COPD患者80例，诊断标准为1997年我国COPD诊治规范（草案）标准［1］，治疗前血气分析提示PaO2lt;8.0 kPa，PaCO2gt;6.67 kPa符合II型呼吸衰竭诊断标准。随机分为治疗组和对照组，每组40例