CAJ | 학술논문

目的：评价双水平气道正压（BiPAP）无创机械通气治疗老年慢性阻塞性肺疾病急性加重期（AECOPD）合并II型呼吸衰竭患者的临床疗效。方法回顾性分析我院2009年12月-2013年5月的46例（其中18例嗜睡、1例浅昏迷）老年AECOPD合并II型呼吸衰竭患者资料，在常规治疗基础上，所有患者接受经口鼻面罩BiPAP无创机械通气。记录治疗前、治疗6 h、治疗3 d的血气分析值（ PH、PaCO2、PaO2、SaO2）、呼吸频率、血压（收缩压、舒张压），并统计分析以上数据。结果经BiPAP无创机械通气治疗后患者病情明显改善，动脉血pH值较治疗前改善、氧分压（ PaO2）高于治疗前、二氧化碳分压（ PaCO2）低于治疗前水平，两者具有统计学意义；3 d疗效优于6 h疗效。无创机械通气对血压无明显影响。结论经口鼻面罩BiPAP无创机械通气是治疗老年COPD急性加重合并II型呼吸衰竭患者的一种安全有效的方法。
목적：평개쌍수평기도정압（BiPAP）무창궤계통기치료노년만성조새성폐질병급성가중기（AECOPD）합병II형호흡쇠갈환자적림상료효。방법회고성분석아원2009년12월-2013년5월적46례（기중18례기수、1례천혼미）노년AECOPD합병II형호흡쇠갈환자자료，재상규치료기출상，소유환자접수경구비면조BiPAP무창궤계통기。기록치료전、치료6 h、치료3 d적혈기분석치（ PH、PaCO2、PaO2、SaO2）、호흡빈솔、혈압（수축압、서장압），병통계분석이상수거。결과경BiPAP무창궤계통기치료후환자병정명현개선，동맥혈pH치교치료전개선、양분압（ PaO2）고우치료전、이양화탄분압（ PaCO2）저우치료전수평，량자구유통계학의의；3 d료효우우6 h료효。무창궤계통기대혈압무명현영향。결론경구비면조BiPAP무창궤계통기시치료노년COPD급성가중합병II형호흡쇠갈환자적일충안전유효적방법。
Objective To study the clinical efficacy of bi-level positive airway pressure(BiPAP) noninvasive mechanical ventilation on elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) combined with type II respiratory failure .Methods A retrospective analysis was conducted on 46 cases of elderly patients of AECOPD combined with type II respiratory failure in our hospital from December 2009 to May 2013,including 18 cases of somnolence and 1 case of superficial coma ,on the basis of routine treatment .All the patients underwent BiPAP noninvasive mechanical ventilation by oral-nasal mask.Blood gas analysis (PH,PaCO2,PaO2, SaO2),respiratory rate and blood pressure (both systolic and dias-tolic) were recorded before treatment ,6 hours and 3 days after treatment respectively ,and statistics were analyzed .Results The patients with BiPAP noninvasive mechanical ventilation remarkably improved after treatment .Arterial blood pH improved compared with that before treatment .The oxygen partial pressure ( PaO2 ) was higher and the partial pressure of carbon dioxide ( PaCO2 ) lower than that before treatment ,both with statistical significance .Efficacy of 3 days was better than that of 6 hours. Noninvasive mechanical ventilation had no effect on blood pressure .Conclusion BiPAP non-invasive mechanical ventilation by oral-nasal mask is a safe and effective method in treatment of elderly patients with AECOPD combined with type II respira -tory failure.