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目的:对24例COPD合并Ⅱ型呼吸衰竭患者无创正压通气治疗血气变化进行分析,总结慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的治疗效果及体会。方法:24例患者均使用无创正压通气,比较治疗前后血气分析参数变化。结果:本组24例患者均有低氧血症和高碳酸血症,经鼻导管吸氧(2L/min)后部分患者的SaO2达90%以上,用等量氧浓度通气治疗后,所有患者SaO2和PaCO2都有明显增加(P<0.05),通气1h,PaCO2虽有下降,但不显著(P>0.05);连续通气2h,PaCO2显著降低(P<0.05),患者持续通气12h以上,PaCO2持续下降,至出院以前PaCO2部分恢复正常,治疗中所有患者的心率降低,血压无明显变化。结论:使用无创正压通气治疗COPD合并呼吸衰竭(Ⅱ型),患者痛苦小,易接受,可以减少有创通气概率,减少住院时间及治疗费用。
Objective: To analyze the changes of blood gas in non-invasive positive pressure ventilation in 24 patients with COPD and type Ⅱ respiratory failure, and to summarize the therapeutic effect and experience of chronic obstructive pulmonary disease with type Ⅱ respiratory failure. Methods: All the 24 patients underwent noninvasive positive pressure ventilation. The changes of blood gas analysis parameters before and after treatment were compared. Results: The 24 patients in this study had hypoxemia and hypercapnia, and the SaO2 of some patients was more than 90% after the nasal catheter was inhaled oxygen (2L / min). After treatment with the same oxygen concentration, all the patients PaCO2 significantly decreased (P <0.05), PaCO2 decreased significantly (P <0.05), PaCO2 decreased significantly (P <0.05), PaCO2 decreased significantly (P <0.05) Continued to decline, to PaCO2 part of the discharge before the return to normal, the treatment of all patients with reduced heart rate, no significant change in blood pressure. Conclusion: Noninvasive positive pressure ventilation for COPD with respiratory failure (type Ⅱ) is less painful and more acceptable. It can reduce the probability of invasive ventilation and reduce hospitalization and treatment costs.