傅万颖 陈菱菱

[摘要]目的 探讨无创正压通气治疗慢性阻塞性肺疾病合并呼吸衰竭的临床效果。 方法 将我院2010～2013年112例慢性阻塞性肺疾病合并呼吸衰竭患者随机分为对照组和实验组，每组各56例，其中对照组采用常规治疗，而实验组采用无创正压通气治疗。比较两组患者的住院时间、插管率、病死率以及治疗前后血气分析的指标（氧分压、二氧化碳分压、pH）。 结果 对照组住院时间、插管率和病死率均明显高于实验组，差异有统计学意义（P<0.05）。两组患者在治疗前氧分压、二氧化碳分压、pH间比较差异无统计学意义（P>0.05），但治疗后对照组氧分压低于实验组，二氧化碳分压高于实验组，差异有统计学意义（P<0.05）。对照组中插管率为15.00%，而实验组插管率为3.57%，差异有统计学意义（P<0.05）。 结论 无创正压通气治疗慢性阻塞性肺疾病合并呼吸衰竭效果较好，改善预后，降低并发症发生率，值得临床推广。

[关键词]无创正压通气；慢性阻塞性肺疾病；呼吸衰竭

[中图分类号]R563 [文献标识码]B [文章编号]2095-0616（2014）20-188-03

Effect of noninvasive positive pressure ventilation in the treatment of chronic obstructive pulmonary disease with respiratory failure

FU Wanying CHEN Lingling

Department of Internal Medicine， Puning Overseas Chinese Hospital Affiliated to Southern Medical University， Puning 515300， China

[Abstract]Objective To explore the effect of noninvasive positive pressure ventilation on chronic obstructive pulmonary disease complicated with respiratory failure. Methods A total of 112 chronic obstructive pulmonary disease patients with complication of respiratory failure admitted from 2010 to 2013 were selected， and randomly divided into control group and experimental group by half in which the control group using conventional treatment， while the experimental group using noninvasive positive pressure ventilation treatment. Then comparing hospitalization， intubation rate， mortality and indicators of blood gas analysis before and after treatment （for example partial pressure of oxygen， carbon dioxide partial pressure， pH）. Results Hospitalization， intubation and mortality rates were compared between two groups， the indicators for control group were significantly higher than the experimental group， the difference was statistically significant （P<0.05）. Partial pressure of oxygen， partial pressure of carbon dioxide and pH were compared between two groups， the difference was without statistically significant （P>0.05） before treatment， but the partial pressure of oxygen in the control group was lower than the experimental group after treatment， however the carbon dioxide partial pressure in the control group was higher than the experimental group after treatment， the difference was statistically significant （P<0.05）.Intubation in the control group was 15.00%， while the experimental group was 3.57% intubation， the difference was statistically significant （P<0.05）. Conclusion Noninvasive positive pressure ventilation is invasive， safe and effect on COPD complicated with respiratory failure. It deserves extensive clinical application.

[Key words]Noninvasive positive pressure ventilation； Chronic obstructive pulmonary disease； Respiratory failure

慢性阻塞性肺疾病（COPD）是一种比较常见的呼吸系统疾病，病程进展缓慢，主要的临床表现是胸闷、喘息、慢性咳嗽、咳痰等[1-2]。一旦出现急性发作会恶化患者肺功能，疾病进入晚期会出现呼吸衰竭，患者存在呼吸困难症状，严重影响患者的身体健康和生活质量。慢性阻塞性肺疾病合并呼吸衰竭的发病率及病死率较高[3]，目前临床常规治疗方法是使用呼吸兴奋剂，但是治疗效果一般。本研究通过无创正压通气治疗与常规治疗方法的比较发现，无创正压通气治疗慢性阻塞性肺疾病合并呼吸衰竭的临床效果较好，现报道如下。

1 资料与方法1.1 一般资料

选取我院2010～2013年112例慢性阻塞性肺疾病合并呼吸衰竭患者，随机分为对照组和实验组，每组各56例。对照组中男30例，女26例，年龄45～65岁，平均（49.9±4.3）岁，病程3.9～16.0年，平均（9.1±1.4）岁；……