CAJ | 학술논문

目的：总结无创正压机械通气( NIPPV)在AECOPD合并呼吸衰竭治疗中的经验。方法160例AECOPD合并呼吸衰竭的患者,采用经口鼻面罩双水平正压通气,吸气峰压为13~25 cmH2 O；呼气末压4~6 cmH2 O。 NIPPV无效者改为有创通气。观察指标包括：临床症状和动脉血气改善情况,根据动脉血气和临床症状的改善情况进行疗效评价。结果①NIPPV总有效率为85%。有效率与病情严重程度、年龄相关：NIPPV有效者,上机前动脉血气状况明显好于无效病例( P <0．05),有效者年龄平均值小于无效者( P <0．05)。②24例NIPPV无效者中,22例改为有创通气,成功率为81．8%。结论①NIPPV对AECOPD合并呼吸衰竭患者的治疗有重要意义,可减少患者气管插管的痛苦和并发症,减少住院费用。②早期上机有利于提高治疗成功率。
목적：총결무창정압궤계통기( NIPPV)재AECOPD합병호흡쇠갈치료중적경험。방법160례AECOPD합병호흡쇠갈적환자,채용경구비면조쌍수평정압통기,흡기봉압위13~25 cmH2 O；호기말압4~6 cmH2 O。 NIPPV무효자개위유창통기。관찰지표포괄：림상증상화동맥혈기개선정황,근거동맥혈기화림상증상적개선정황진행료효평개。결과①NIPPV총유효솔위85%。유효솔여병정엄중정도、년령상관：NIPPV유효자,상궤전동맥혈기상황명현호우무효병례( P <0．05),유효자년령평균치소우무효자( P <0．05)。②24례NIPPV무효자중,22례개위유창통기,성공솔위81．8%。결론①NIPPV대AECOPD합병호흡쇠갈환자적치료유중요의의,가감소환자기관삽관적통고화병발증,감소주원비용。②조기상궤유리우제고치료성공솔。
Objective To sum up the experience of non-invasive positive pressure ventilation ( NIPPV) in the treatment of AECOPD patients complicated with acute respiratory failure. Methods 160 AECOPD patients com-plicated with acute respiratory failure received NIPPV via full face-mask were enrolled in the study. 13~25 cmH2 O of inspiratory peak airway pressure ( IPAP) and 4~6 cmH2 O of expiratory peak airway pressure ( EPAP) were deliv-ered. Invasive positive pressure ventilation was delivered when NIPPV failed. Their clinical status, changes of artery blood gases and ventilator application were observed. Results ①The total effective rate of NIPPV was 85%, which was related with the state of illness and age. NIPPV benefited patients were shown to produce significant improve-ments in arterial blood gases (P<0. 05), and they were younger than those ineffective patients (P<0. 05). ②22 patients, who failed NIPPV, received invasive positive pressure ventilation, and the effective rate was 81. 8%. Con-clusion ① NIPPV is important in the treatment of AECOPD patients complicated with acute respiratory failure, which can decrease the pain of invasive positive pressure ventilation and medical treatment cost. ② The early use of NIPPV can improve the effective rate.