刘林

【摘要】 目的：探究慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者應用无创通气治疗的临床疗效。方法：选择笔者所在医院2011年1月-2015年12月收治的37例慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者，根据治疗方法不同进行分组，对照组18例采用气管插管治疗，观察组19例采用无创通气治疗，比较两组患者呼吸改善情况、治疗效果及并发症情况。结果：观察组患者治疗24 h后HR（90.17±5.08）次/min、BR（21.18±2.35）次/min、PaO2（83.75±5.74）mm Hg、PaCO2（42.65±7.51）mm Hg，均显著优于对照组（P<0.05）。对照组治疗总有效率为72.22%，观察组总有效率为94.74%，观察组患者治疗总有效率显著高明显高于对照组，比较差异有统计学意义（P<0.05）。对照组并发症发生率为27.77%，死亡率为11.11%；观察组并发症发生率为10.53%，死亡率为0。结论：无创通气治疗可减小对慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者呼吸道的损伤，改善患者血气分析指标，帮助患者恢复自主呼吸能力，降低并发症发生率，显著提高患者的抢救成功率。

【关键词】 慢性肺阻塞性疾病； Ⅱ型呼吸衰竭； 无创通气治疗； 治疗效果

doi：10.14033/j.cnki.cfmr.2017.32.012 文献标识码 B 文章编号 1674-6805（2017）32-0025-03

Clinical Observation of Noninvasive ventilation in the Treatment of Chronic Obstructive Pulmonary Disease Combined Type Ⅱ Respiratory Failure/LIU Lin.//Chinese and Foreign Medical Research，2017，15（32）：25-27

【Abstract】 Objective：To explore the clinical efficacy of noninvasive ventilation in patients with chronic obstructive pulmonary disease combined with type Ⅱ respiratory failure.Method：From January 2011 to December 2015，37 patients of chronic obstructive pulmonary disease combined with type Ⅱ respiratory failure treated in our hospital were enrolled in this study.According to the different treatment methods，18 patients in the control group were treated with tracheal intubation and 19 patients in the observation group were treated noninvasive ventilation treatment，respiratory improvement，therapeutic effect and complication in two groups were compared.Result：The observation group patients after treatment of 24 h of HR （90.17±5.08）times/min，BR （21.18±2.35）times/min，PaO2 （83.75±5.74）mm Hg，PaCO2 （42.65±7.51）mm Hg，were significantly better than those of the control group（P<0.05）.In the control group，the total effective rate was 72.22%，in the observation group，the total effective rate was 94.74%，the total effective rate of the observation group was significantly higher than the control group，and the difference was statistically significant（P<0.05）.The incidence of complications and the mortality rate in the control group were 27.77% and 11.11%；the incidence of complications and the mortality rate in the observation group were 10.53% and 0.Conclusion：Noninvasive ventilation treatment can reduce the risk of respiratory track injury in patients with chronic obstructive pulmonary disease combined with type Ⅱ respiratory failure，improve the patients blood gas analysis index，help patients to restore spontaneous breathing capacity，reduce complication rate，significantly improve the rescue success rate of the patients.endprint

【Key words】 Chronic obstructive lung disease； TypeⅡ respiratory failure； Noninvasive ventilation treatment； Treatment effect

First-authors address：Hongquan Hospital in Yangzhou，Yangzhou 225200，China

慢性阻塞性肺疾病是指机体肺部结构出现阻塞性病变，患者呼吸道气流受限，在出现气道分泌物梗阻或呼吸道感染时极易引发呼吸衰竭并发症，具有较高致死率，对患者的生命造成严重威胁[1]。在慢性阻塞性肺疾病合并呼吸衰竭治疗中，抢救的关键是保持患者呼吸道顺畅，通过机械通气方法帮助患者辅助呼吸，避免患者脑组织、心血管等器官出现缺血缺氧性病变[2]。在传统治疗中，以抗痉挛、平喘、祛痰等药物治疗为主要方法，但药物治疗起效缓慢，呼吸功能进一步衰竭退化，而有创气管插管辅助通气治疗损伤性大且并发症多，预后不佳[3]。无创通气技术近几年来在国内呼吸窘迫和呼吸抑制治疗中推广应用，既不对患者造成气道损伤，还具有操作简单、安全性高、起效迅速的特点[4]。本文为探究无创通气技术在慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭抢救治疗中的应用效果，以笔者所在医院37例患者作为研究对象，探究不同机械辅助通气治疗方法下患者的抢救成功率及恢复效果，现报道如下。……