家庭双水平无创正压机械通气对稳定期极重度COPD患者疗效观察.docVIP

家庭双水平无创正压机械通气对稳定期极重度COPD患者疗效观察 　　[摘要] 目的：观察双水平气道正压通气（BIPAP）在极重度慢性阻塞性肺疾病（COPD）患者稳定期康复治疗中的疗效。方法：将42例极重度COPD稳定期患者随机分为两组，对照组（21例）采用单纯家庭氧疗，治疗组（21例）采用BIPAP治疗，两组均治疗2年。在治疗期间所有入选患者均被要求戒烟，行缩唇呼吸或腹式呼吸等肺康复锻炼，必要时给予化痰治疗。分析患者治疗前及治疗2年后的动脉血气、肺通气功能、6 min步行距离、年住院率的变化。结果：治疗前治疗组与对照组的动脉血二氧化碳分压（PaCO2）、动脉血氧分压（PaO2）、每年住院次数、第1秒用力呼气容积（FEV1）、用力肺活量（FVC）、6 min步行距离差异均无统计学意义（t=0.886、-0.666、2.630、-0.024、0.095、0.635，均P0.05）；治疗2年后治疗组死亡4例（4/21），对照组死亡6例（6/21），两组比较差异无统计学意义（P0 05）；治疗2年后治疗组PaCO2、PaO2、每年住院次数、FEV1、FVC及6 min步行距离与对照组比较，差异均有统计学意义（t=-16.857、5.752、-16.053、2.684、3.338、7.644，均P 　　[关键词] 极重度慢性阻塞性肺疾病；稳定期；双水平气道正压通气；疗效 　　[中图分类号] R563.805；R459.6 [文献标识码] B [文章编号] 1673-7210（2012）01（a）-132-03 　　 　　Curative effects of home bi-level non-invasive positive airway pressure ventilation in the treatment of patients with severe chronic obstructive pulmonary disease of stable phase 　　ZHENG Xiaolu, LI Mingsheng, WEU Houhua 　　Department of Respiratory Medicine, Pingdingshan Coal Group General Hospital, Henan Province, Pingdingshan 467000, China 　　[Abstract] Objective: To observe the curative effects of bi-level non-invasive positive airway pressure (BIPAP) ventilation in the rehabilitation treatment of patients with severe chronic obstructive pulmonary disease (COPD) of the stable phase. Methods: 42 cases of patients with severe stable phase COPD were randomly divided into 2 groups. The control group was received simple home oxygen therapy, while the treatment group was received BIPAP treatment for 2 years. During the treatment period, all selected patients were required to quit smoking, do pursed-lip breathing or abdominal breathing and other pulmonary rehabilitation exercise, and were received phlegm removing treatment if necessary. The changes of arterial blood gases, lung function, 6-minute walk distance and annual hospitalization rate before treatment and 2 years after treatment were analyzed. Results: Before treatment, the arterial partial pressure of carbon dioxide (PaCO2), arterial partial pressure of