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目的:探讨无创正压通气(NPPV)治疗急性呼吸性酸中毒的临床疗效及应用时机。方法:将确诊为慢性阻塞性肺疾病急性加重(AECOPD)合并急性呼吸性酸中毒68例患者按血气分析的酸中毒程度分别分为3组,其中A组26例(轻度酸中毒组),B组22例(轻度酸中毒组)、C组20例(较严重呼吸性酸中毒组),A组作为常规治疗对照组,B、C组在常规治疗基础上均作NPPV,对比治疗2h后3组患者呼吸频率及动脉血pH值和PaCO2的变化、24h后患者的临床疗效和pH值恢复正常的人数,入组患者治疗前后均作saps(Ⅱ)评分并进行统计学分析。结果:治疗后3组患者进行两两比较,B组与A、C组相比,患者的临床症状改善明显(P<0.05),其有效率分别为65.39%、95.45%和65.00%,差异有统计学意义。3组患者治疗2h后pH值和PaCO2明显好转,3组患者治疗后的saps(Ⅱ)评分均有不同程度降低,酸中毒纠正人数增加。结论:NPPV能有效纠正急性呼吸性酸中毒,对中重度AECOPD合并急性呼吸性酸中毒患者早期使用有明显的临床疗效,不会延误AECOPD患者的治疗。
Objective: To investigate the clinical efficacy and timing of noninvasive positive pressure ventilation (NPPV) in the treatment of acute respiratory acidosis. Methods: Sixty-eight patients diagnosed as acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with acute respiratory acidosis were divided into three groups according to their degree of acidosis: 26 patients in group A (mild acidosis group) 22 cases in group B (mild acidosis group), 20 cases in group C (severe respiratory acidosis group), group A as routine treatment control group, group B and group C were treated with NPPV on the basis of conventional treatment, compared with 2 hours Respiratory rate, arterial blood pH and PaCO2 in the latter three groups were measured. After 24 hours, the clinical efficacy and the number of patients with normal pH value were recovered. The patients were divided into two groups before and after treatment. Results: Compared with A and C groups, the clinical symptoms of patients in group B were significantly improved (P <0.05) after treatment, and the effective rates were 65.39%, 95.45% and 65.00%, respectively Statistical significance. The pH and PaCO2 of the 3 groups were significantly improved after 2 hours of treatment. The saps (Ⅱ) scores of the 3 groups of patients decreased to some extent after treatment, and the number of people with acidosis increased. Conclusion: NPPV can effectively correct acute respiratory acidosis and has obvious clinical effect on early use of moderate and severe AECOPD patients with acute respiratory acidosis, and will not delay the treatment of AECOPD patients.