CAJ | 학술논문

目的：探讨双水平气道正压通气（ BiPAP）对慢性阻塞性肺疾病急性加重期（ AECOPD）合并II型呼吸衰竭患者的治疗效果。方法选取AECOPD合并II型呼吸衰竭患者120例分为2组，每组60例。2组均给予常规治疗，治疗组予以BiPAP，对照组予以持续低流量鼻导管吸氧，观察2组治疗前及治疗72 h的心率、呼吸频率、pH值、二氧化碳分压（PaCO2）、氧分压（PaO2）、血氧饱和度（SaO2），以及平均住院时间。结果2组患者心率、呼吸频率、PaCO2均较治疗前下降（ P ＜0 J．01），pH值、PaO2、SaO2均较治疗前明显增加（ P ＜0．01）；且治疗组患者心率、呼吸频率、PaCO2下降幅度明显高于对照组，PaO2、SaO2上升幅度明显高于对照组（ P ＜0．01或P ＜0．05）；治疗后2组pH值无明显差异（ P ＞0．05）。平均住院时间对照组为（10．81±3．26）d，多于治疗组的（9．41±2．73）d，差异有统计学意义（ P ＜0．05）。结论双水平气道正压通气对AECOPD合并II型呼吸衰竭患者的低氧血症及二氧化碳潴留有明显疗效，能改善氧合，缩短住院时间，值得推广。
목적：탐토쌍수평기도정압통기（ BiPAP）대만성조새성폐질병급성가중기（ AECOPD）합병II형호흡쇠갈환자적치료효과。방법선취AECOPD합병II형호흡쇠갈환자120례분위2조，매조60례。2조균급여상규치료，치료조여이BiPAP，대조조여이지속저류량비도관흡양，관찰2조치료전급치료72 h적심솔、호흡빈솔、pH치、이양화탄분압（PaCO2）、양분압（PaO2）、혈양포화도（SaO2），이급평균주원시간。결과2조환자심솔、호흡빈솔、PaCO2균교치료전하강（ P ＜0 J．01），pH치、PaO2、SaO2균교치료전명현증가（ P ＜0．01）；차치료조환자심솔、호흡빈솔、PaCO2하강폭도명현고우대조조，PaO2、SaO2상승폭도명현고우대조조（ P ＜0．01혹P ＜0．05）；치료후2조pH치무명현차이（ P ＞0．05）。평균주원시간대조조위（10．81±3．26）d，다우치료조적（9．41±2．73）d，차이유통계학의의（ P ＜0．05）。결론쌍수평기도정압통기대AECOPD합병II형호흡쇠갈환자적저양혈증급이양화탄저류유명현료효，능개선양합，축단주원시간，치득추엄。
Objective To investigate the effect of Bi level positive airway pressure ventilation ( BiPAP ) on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients with type II respiratory failure .Methods 120 pa-tients with AECOPD complicated with type II respiratory failure were divided into 2 groups, 60 cases in each group.TWO groups were given conventional treatment ,the treatment group was given BiPAP , the control group was given continuous nasal catheter inhalation of low flow oxygen,before and after treatment, heart rate, respiratory frequency, pH 72 h value of pressure, carbon dioxide ( PaCO2 ) , partial pressure of oxygen ( PaO2 ) , oxygen saturation ( SaO2 ) , and the average hospitalization time were observed in the 2 groups.Results The heart rate, respiratory frequency , PaCO2 of the 2 groups were significantly re-duced ( P <0.01), pH value, PaO2, SaO2 were significantly increased than before treatment ( P <0.01); and the treat-ment group patients’ heart rate, respiratory rate, PaCO2’s decline was significantly greater than the control group , PaO2, SaO2 markedly increased than that of the control group ( P <0.01 or P <0.05);no significant difference of pH values were found in the 2 groups after treatment ( P >0.05).The average duration time of the control group was (10.81 ±3.26) d, longer than the treatment group’s (9.41 ±2.73) d, the difference was statistically significant ( P <0.05).Conclusion It suggested that BiPAP ventilation on patients with AECOPD complicated with hypoxemia , hypercapnia and type II respiratory failure has obvious curative effect , it can improve oxygenation , and shorten the time of hospitalization , worthy of promotion .