无创正压通气在AECOPD合并Ⅱ型呼吸衰竭早期伴有意识障碍患者中临床应用研究.docVIP

无创正压通气在AECOPD合并Ⅱ型呼吸衰竭早期伴有意识障碍患者中临床应用研究 　　[摘要] 目的 研究无创正压通气在AECOPD合并Ⅱ型呼吸衰竭早期伴有意识障碍患者中的临床应用效果。 方法 对2011年3月～2014年6月我院收治的160例AECOPD合并Ⅱ型呼吸衰竭早期伴有意识障碍患者进行回顾性分析，采取有创机械通气治疗的80例患者为对照组，采取无创正压通气治疗的80例患者为观察组。观察比较两组患者治疗前后的呼吸频率（RR）、心率（HR）、动脉PaO2以及PaCO2指标的变化情况。 结果 治疗后，观察组80例患者的治疗总有效率为81.25%，明显高于对照组的63.75%，组间差异有统计学意义（P0.05）；两组患者的临床症状及指标均获得明显改善，研究组患者的呼吸频率、心率等显著下降，并趋于正常，动脉血气PaO2明显升高、PaCO2显著降低，与对照组相比差异有统计学意义（P0.05）。 结论 无创正压通气在AECOPD合并Ⅱ型呼吸衰竭早期伴有意识障碍患者的临床治疗中效果显著，能有效的改善患者的意识、临床症状、呼吸频率、心率、动脉血气等症状。值得广泛推广和应用。 　　[关键词] 无创正压通气；AECOPD；Ⅱ型呼吸衰竭；临床效果 　　[中图分类号] R563.8 [文献标识码] B [文章编号] 2095-0616（2015）06-173-03 　　Clinical application study of noninvasive positive pressure ventilation on early stage of AECOPD combined typeⅡ respiratory failure of patients with conscious disturbance 　　FENG Shuping LIANG Shaohong 　　Department of Respiratory， Liwan Hospital of Guangzhou Medical College， Guangzhou 510170， China 　　[Abstract] Objective To study the effect of clinical application of noninvasive positive pressure ventilation（NIPPV） on early stage of AECOPD combined typeⅡ respiratory failure of patients with conscious disturbance. Methods 160 patients with conscious disturbance at early stage of AECOPD combined typeⅡ respiratory failure， who were treated in our hospital from March 2011 to June 2014， were retrospectively analyzed， and divided into control group of 80 patients who were treated with invasive mechanical ventilation（MV） and observation group of 80 patients who were treated with NIPPV. To observe and compare the changes of respiratory rate（RR）， heart rate（HR）， the indexes of artery PaO2 and PaCO2 of patients pre and post treatment between the two groups. Results The total effective rate of treatment after operation in observation group（81.25%） was obviously higher than which in control group（63.75%）， the differences was statically significant between the two groups（P 　　[Key words] Noninvasive positive pressure ventilation； AECOPD；Type Ⅱ respiratory failure； Clinical effect 　　目前，在临床上对于呼吸衰竭的重要治