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BiPAP无创通气对COPD并重度呼吸衰竭的疗效
引用本文:覃庆武,汤渝玲,王建湘,周志国. BiPAP无创通气对COPD并重度呼吸衰竭的疗效[J]. 湘南学院学报(自然科学版), 2011, 0(1): 4-6
作者姓名:覃庆武  汤渝玲  王建湘  周志国
作者单位:长沙市第一医院呼吸内科,湖南长沙410005
摘    要:目的评估无创正压通气(NIPPV)在治疗慢性阻塞性肺疾病(COPD)并重度呼吸衰竭或伴有不同程度意识障碍患者中的价值,为更好地选择NIPPV的临床应用适应症提供依据。方法对79例COPD并重度呼吸衰竭或伴有不同程度意识障碍的患者使用BiPAP呼吸机辅助通气,动态观察NIPPV治疗前和治疗后2—4h、24h、3d及5d动脉血气、意识、治疗后患者的转归、NIPPV的不良反应及并发症。结果79例患者经NIPPV治疗,与治疗前比较,68例患者PaCO2明显降低、pH升高,均脱机出,有效率达86.1%;7例改为有创通气,4例放弃治疗。结论BiPAP无创通气是治疗COPD并重症呼吸衰竭或伴有不同程度意识障碍患者的有效手段;意识障碍并非无创通气的绝对禁忌。

关 键 词:无创正压通气  慢性阻塞性肺疾病  呼吸衰竭  意识障碍

Clinical investigation of bi- level non- invasive positive pressure ventilation in treatment for patients with chronic obstructive pulmonary disease and severe respiratory failure
Affiliation:QIN Qingwu, TANG Yuling, WANG Jianxiang, et al (Department of Respiratory Medicine, The First Hospital of Changsha, Changsha, Hunan 410005, China)
Abstract:Objective To evaluate the value of non - invasive positive pressure ventilation (NIPPV) in the treatment of chronic obstructive pulmonary disease(COPD) with severe respiratory failure or disturbed consciousness. Methods 79 patients with acute exacerbation of COPD and severe respiratory failure complicated or with different degree sive positive of conscious disturbances were enrolled. Subjects received assisted ventilation by bi - level noninvaventilator. The change of arterial blood gas, conscious state , outcome and complications of NIPPV were investigated. Results NIPPV declined PaCO2 significantly, elevated blood pH in 68 patients but 7 subjects who switched to invasive ventilation, 4 gave up the treatment. Conclusion Bi - level noninvasive positive ventilation is a effective therapy for the patients with acute exacerbation of COPD and severe respiratory failure or disturbed consciousness. The conscious disturbances is not the contraindication for NIPPV.
Keywords:Non- invasive positive pressure ventilation  Chronic obstructive pulmonary disease  Respiratory failure  disturbance of consciousness
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