CAJ | 학술논문

目的：观察无创正压通气间歇性与持续性治疗慢性阻塞性肺疾病急性加重合并呼吸衰竭的临床效果。方法同期住院接受无创通气的患者70例，随机分成2组，即间歇无创通气组（ A组常规治疗＋间歇无创通气）及持续无创通气组（B组常规治疗＋持续无创通气），比较两组血气变化、住院天数及气管插管率。结果两组通气治疗后12h、24h、48h、72h后pH值、PaCO2、PaO2与治疗前差异有统计学意义（P＜0．05）；持续无创通气治疗后24h、48h后pH值与间歇通气治疗后差异有统计学意义（P＜0．05），持续无创通气治疗后24h、48h、72h后PaCO2、PaO2与间歇通气治疗后差异有统计学意义（P＜0．05）；持续无创通气组平均住院天数（21．37±5．83）比间歇无创通气组（24．48±5．47）缩短（P＜0.05）；两组治疗后气管插管率差异无统计学意义（P＞0．05）。结论使用无创通气治疗可以明显改善急性加重合并呼吸衰竭患者的通气情况，且在早期应用无创通气时间应每天大于20小时，可较早改善血气情况，减少住院时间。
목적：관찰무창정압통기간헐성여지속성치료만성조새성폐질병급성가중합병호흡쇠갈적림상효과。방법동기주원접수무창통기적환자70례，수궤분성2조，즉간헐무창통기조（ A조상규치료＋간헐무창통기）급지속무창통기조（B조상규치료＋지속무창통기），비교량조혈기변화、주원천수급기관삽관솔。결과량조통기치료후12h、24h、48h、72h후pH치、PaCO2、PaO2여치료전차이유통계학의의（P＜0．05）；지속무창통기치료후24h、48h후pH치여간헐통기치료후차이유통계학의의（P＜0．05），지속무창통기치료후24h、48h、72h후PaCO2、PaO2여간헐통기치료후차이유통계학의의（P＜0．05）；지속무창통기조평균주원천수（21．37±5．83）비간헐무창통기조（24．48±5．47）축단（P＜0.05）；량조치료후기관삽관솔차이무통계학의의（P＞0．05）。결론사용무창통기치료가이명현개선급성가중합병호흡쇠갈환자적통기정황，차재조기응용무창통기시간응매천대우20소시，가교조개선혈기정황，감소주원시간。
Objective To explore the clinical effect of intermittent and continual non-invasive positive pressure ventila-tion(NPPV) in the treatment of chronic obstructive pulmonary disease(COPD) with respiratory failure.Methods Of 70 cases were randomly divided into two groups.Group A was treated with routine method and intermittent NPPV,whereas the group B was treated with routine method and continual NPPV.The arterial blood gas analysis,length of stay and the rate of endotracheal intu-bation were recorded in 12h, 24h, 48h and 72h respectively.Results There was a significant difference in value of pH, PaO2 and PaCO2 between before and after treatment(P<0.05).There was statistical difference between the two groups in value of pH after 24h, 48h of treatment(P<0.05).There was statistical difference between the two groups in PaO2 and PaCO2 after 24h, 48h, 72h of treatment(P<0.05).The group B was shortened compare to group A(P<0.05).There was no statistical difference in the rate of endotracheal intubation between the two groups (P>0.05).Conclusion Noninvasive ventilation can improve the arterial blood gas, lower length of stay in the patient with respiratory failure by COPD.Noninvasive ventilation should be early ap-plication and the Noninvasive ventilation time should be more than twenty hours every day.