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目的探讨无创正压机械通气(NIPPV)在慢性阻塞性肺疾病(COPD)急性加重期的治疗指征和价值。方法采用前瞻性随机对照研究将46例COPD患者随机分为标准治疗对照组和标准治疗加双水平正气道压力通气(B iPAP)观察组,分别于入选后2h、24h、72h、7d观察患者生命体征,监测血气分析和氧饱和度,从而比较两组患者的气体交换情况、住院时间、病死率及气管插管率等指标的差异。结果入组后2h、24h、72h、7d观察组较对照组PaCO2明显降低。观察组总的气管插管率明显降低(P<0.05),住院时间明显缩短(P<0.01)。结论COPD急性加重期应用B iPAP可明显增加患者的气体交换,改善患者的预后,减轻患者的痛苦。
Objective To investigate the indications and values of NIPPV in the treatment of acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods Forty-six patients with COPD were randomly divided into a standard treatment group and a standard bipolar group (B iPAP) group. The patients were followed up for 2h, 24h, 72h, 7d Signs, monitoring of blood gas analysis and oxygen saturation, to compare the two groups of patients with gas exchange, hospital stay, mortality and tracheal intubation rates and other indicators of difference. Results At 2h, 24h, 72h, 7d after operation, PaCO2 in observation group was significantly lower than that in control group. The total tracheal intubation rate in the observation group was significantly lower (P <0.05), hospitalization time was significantly shorter (P <0.01). Conclusion B iPAP can significantly increase the gas exchange in patients with acute exacerbation of COPD, improve the prognosis of patients and reduce the suffering of patients.