中国医药科学
中國醫藥科學
중국의약과학
CHINA MEDICINE AND PHARMACY
2014年
14期
37-40
,共4页
无创双水平正压通气(BiPAP)%慢性阻塞性肺疾病(COPD)%急性加重期%Ⅱ型呼吸衰竭%应用时机
無創雙水平正壓通氣(BiPAP)%慢性阻塞性肺疾病(COPD)%急性加重期%Ⅱ型呼吸衰竭%應用時機
무창쌍수평정압통기(BiPAP)%만성조새성폐질병(COPD)%급성가중기%Ⅱ형호흡쇠갈%응용시궤
Noninvasive bi level positive airway pressure(BiPAP)%Chronic obstructive pulmonary disease(COPD)%Acute exacerbation%TypeⅡrespiratory failure%Application time
目的：探讨慢性阻塞性肺疾病（COPD）急性加重期合并Ⅱ型呼吸衰竭患者运用无创双水平正压通气（BiPAP）的合理时机。方法66例COPD急性加重期合并Ⅱ型呼吸衰竭患者按pH值≤7.25分为严重呼吸性酸中毒组（A组），7.25＜pH值＜7.35为中度呼吸性酸中毒组（B组），pH值≥7.35为轻度呼吸性酸中毒组（C组），每组22例；再将ABC三组每组22例患者随机分为研究组和对照组各11例，对照组进行常规治疗，研究组在此基础上施以BiPAP通气，比较两组治疗前、治疗2h后的血气分析变化。结果pH值≤7.25组（A组）：两小组疗效均不理想；7.25＜pH值＜7.35组（B组）：研究组疗效显著，对照组效果有限，两组疗效有显著差异（P＜0.05）；pH≥7.35组（C组）：两组均有显效，但组间比较差异无统计学意义（P＞0.05）。结论在COPD急性加重期合并Ⅱ型呼吸衰竭患者应用BiPAP通气时，中度呼吸性酸中毒患者效果最佳，对轻、重度衰竭患者的治疗效果影响不明显。
目的：探討慢性阻塞性肺疾病（COPD）急性加重期閤併Ⅱ型呼吸衰竭患者運用無創雙水平正壓通氣（BiPAP）的閤理時機。方法66例COPD急性加重期閤併Ⅱ型呼吸衰竭患者按pH值≤7.25分為嚴重呼吸性痠中毒組（A組），7.25＜pH值＜7.35為中度呼吸性痠中毒組（B組），pH值≥7.35為輕度呼吸性痠中毒組（C組），每組22例；再將ABC三組每組22例患者隨機分為研究組和對照組各11例，對照組進行常規治療，研究組在此基礎上施以BiPAP通氣，比較兩組治療前、治療2h後的血氣分析變化。結果pH值≤7.25組（A組）：兩小組療效均不理想；7.25＜pH值＜7.35組（B組）：研究組療效顯著，對照組效果有限，兩組療效有顯著差異（P＜0.05）；pH≥7.35組（C組）：兩組均有顯效，但組間比較差異無統計學意義（P＞0.05）。結論在COPD急性加重期閤併Ⅱ型呼吸衰竭患者應用BiPAP通氣時，中度呼吸性痠中毒患者效果最佳，對輕、重度衰竭患者的治療效果影響不明顯。
목적：탐토만성조새성폐질병（COPD）급성가중기합병Ⅱ형호흡쇠갈환자운용무창쌍수평정압통기（BiPAP）적합리시궤。방법66례COPD급성가중기합병Ⅱ형호흡쇠갈환자안pH치≤7.25분위엄중호흡성산중독조（A조），7.25＜pH치＜7.35위중도호흡성산중독조（B조），pH치≥7.35위경도호흡성산중독조（C조），매조22례；재장ABC삼조매조22례환자수궤분위연구조화대조조각11례，대조조진행상규치료，연구조재차기출상시이BiPAP통기，비교량조치료전、치료2h후적혈기분석변화。결과pH치≤7.25조（A조）：량소조료효균불이상；7.25＜pH치＜7.35조（B조）：연구조료효현저，대조조효과유한，량조료효유현저차이（P＜0.05）；pH≥7.35조（C조）：량조균유현효，단조간비교차이무통계학의의（P＞0.05）。결론재COPD급성가중기합병Ⅱ형호흡쇠갈환자응용BiPAP통기시，중도호흡성산중독환자효과최가，대경、중도쇠갈환자적치료효과영향불명현。
Objective To study the reasonable time to use non-invasive bilevel positive airway pressure(BiPAP) of chronic obstructive pulmonary disease(COPD) in acute exacerbation in patients with typeⅡ respiratory failure. Methods 66 cases of acute exacerbation of COPD with type Ⅱ respiratory failure were divided into three groups according to the pH value: pH ≤ 7.25 for severe respiratory acidosisgroup(group A),7.25<pH value<7.35 for moderate respiratory acidosis group(group B), pH ≥ 7.35 for mildrespiratory acidosis group(C group), each group of 22 cases;Then the three groups each of 22 patients were randomly divided into study group and control group with 11 cases in each group, the control group was given conventional treatment, study group on the basis of analysis with BiPAP ventilation, the blood gas changes were compared between two groups before treatment and after 2h. Results The pH≤7.25 group(A group):two groups of curative effect was not ideal;B group:Research group of good curative effect, the control group Limited, there was significant difference between the two groups(P < 0.05); pH ≥ 7.35 group(C group); two groups were markedly, but the comparison between groups was no significant difference(P> 0.05). Conclusion In the period with type Ⅱ respiratory failure were treated with BiPAP ventilation in acute exacerbation of COPD, moderate respiratory acidosis in patients with best effect, mild, severe failure in patients with the treatment effect is not obvious.
