无创正压通气救治慢性阻塞性肺疾病并重度呼吸衰竭的临床探讨.docVIP

精品论文 参考文献 无创正压通气救治慢性阻塞性肺疾病并重度呼吸衰竭的临床探讨 刘斌 [摘 要]目的 本研究主要就无创正压通气（NIPPV）救治慢性阻塞性肺疾病（COPD）并重度呼吸衰竭的临床效果展开分析讨论。方法 选择我院2012年4月—2013年4月所收治的31例COPD急性加重期合并呼吸衰竭的患者作为研究对象，对于急性加重期且存在呼吸衰竭的患者采用双水平的无创正压呼吸机面罩来对患者进行辅助通气，对患者在接受无创正压通气前以及通气后4h、10h、1d、3d患者的动脉血气变化进行观察、比较。结果 本研究所有患者中，有27例患者在经过3天的治疗后，其体内的pH值、PaCO2水平以及PaO2水平与治疗前存在明显差异，具有统计学意义，p＜0.05。所有患者的治疗有效率达到了87.09%，4例患者在治疗的过程中转为有创通气治疗。结论 在对COPD急性加重期合并呼吸衰竭的患者进行治疗时，NIPPV的疗效相对较好，不过，在使用的过程中，一定要对无创呼吸机的使用方法进行正确的掌握，并对其各类参数进行合理的调节，尤其是吸气过程中的支持压力。 [关键词]慢性阻塞性肺疾病 无创正压通气 重度呼吸衰竭 临床探讨 A Clinical Exploration of Curing COPD with Severs Respiratory Failure through NIPPV Liu Bin Abstract: Objective To explore the clinical effect of curing chronic obstructive pulmonary diseases (COPD) with severs respiratory failure through non-invasive positive pressure ventilation (NIPPV). Methods 31 patients of acute exacerbation of COPD with severs respiratory failure in Jiangyinshi Qingyang Hospital from April 2012 to April 2013 were selected in the research. Bi-level non-invasive ventilator was applied to provide assist ventilation to the patients, and their arterial blood gas changes were compared and analyzed 4h, 10h, 1d, 3d after their receiving NIPPV. Results The pH value, PaCO2 level, and PaO2 level in 27 cases of all the 31 cases, 3 days after the treatment, were different from before, which is of statistic meaning, (p＜0.05). The effective rate of all the patients has reached up to 87.09%, with 4 patients transferred to invasive ventilation during the treatment. Conclusion NIPPV is more efficient in curing COPD with severs respiratory failure. However, the correct use of the ventilator and reasonable regulation of indicators are very important in applying it. Key words: COPD; NIPPV; severs respiratory failure; clinical exploration 目前，在对慢性阻塞性肺疾病急性加重期合并呼吸衰竭的患者进行治疗时，无创正压通气得到了十分广泛的应用。有研究资料表明，无创正压通气对于轻度或中度呼吸衰竭的治疗效果相对较为明显，但对于COPD急性加重期合并呼吸衰竭的患者却一直被列为治疗过程中禁忌。本研究将对我院31例COPD急性加重期合并呼吸衰竭的患者采用NIPPV进行治疗的临床情况进行回顾性分析，现报告如下。 1. 一般资料与方法