Clinical Investigation of Non-Invasive Positive Pressure Ventilation in Treatment for Patients with Chronic Obstructive Pulmonary Disease and Severe Respiratory Failure_West China Medical Journal

Authors：

HE Zhengguang , QIU Rong , XIAO Changwu.

Department of Respiratory, Suining Central Hospital, Suining Sichuan 629000, China;

Corresponding author：

Keywords：

无创正压通气; 慢性阻塞性肺疾病; 呼吸衰竭

Video：

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目的:评价无创正压通气(NIPPV)在救治慢性阻塞性肺疾病(COPD)急性加重期并严重呼吸衰竭患者中的临床疗效。方法:对2006年1月至2008年1月入选的47例COPD急性加重期并严重呼吸衰竭患者使用双水平无创正压呼吸机面罩辅助通气, 患者均伴有不同程度的意识障碍,动态观察NIPPV治疗前和治疗后2 h、8 h、1 d及3 d动脉血气、神志、治疗后患者的转归,NIPPV的不良反应及并发症。结果:本组47例患者中,41例经NIPPV治疗2 h、8 h、1 d及3 d后与治疗前比较,PaO2明显升高P lt;0.01,PaCO2明显降低P lt;0.01,pH明显升高P lt;0.01,均脱机出院,有效率达87.23%(41/47);6例改为有创通气,其中3例经有创机械通气治疗后脱机成功,1例因上消化道出血死亡,2例自动出院.结论:双水平无创正压通气对有选择的COPD急性加重期并严重呼吸衰竭患者治疗疗效确切,它能迅速缓解病情,减少患者的气管插管和气管切开以及相应的并发症,提高生活质量。

Citation： HE Zhengguang,QIU Rong,XIAO Changwu.. Clinical Investigation of Non-Invasive Positive Pressure Ventilation in Treatment for Patients with Chronic Obstructive Pulmonary Disease and Severe Respiratory Failure. West China Medical Journal, 2009, 24(7): 1724-1726. doi: Copy

1.	PAUWELS R A, BUISTAS, CALVERLEY P M, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLB /WHO Global Initiative for chronic Obstructive Lung Disease (GOLD) work shop summary[J]. Am J Respir Crit CareMed,2001,163(5):1256-1276.
2.	中华医学会呼吸病学分会慢性阻塞性肺疾病学组. 慢性阻塞性肺疾病诊治指南[J]. 中华结核和呼吸杂志, 2002,25(8):453-460.
3.	胡国萍. 经面罩无创机械通气治疗慢性阻塞性肺疾病合并重症呼吸衰竭[J].中国呼吸与危重监护杂志,2004,3(3):176.
4.	钮善福.进一步拓宽面罩机械通气的临床适应证[J].中国呼吸与危重监护杂志, 2002,1(4):197-198.
5.	梁建忠,李小玲,潘陶涛,等.无创正压通气治疗慢性阻塞性肺疾病并严重呼吸衰竭的临床研究[J].第四军医大学学报,2007,28(22):2079-2081.
6.	ATS. International Consensus Conferences in Intensive Care Medicine:noninvasive positive pressure ventilation in acute respiratory failure[J]. Am J Respir Crit Care Med,2001,163(1):283-291.

1. PAUWELS R A, BUISTAS, CALVERLEY P M, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLB /WHO Global Initiative for chronic Obstructive Lung Disease (GOLD) work shop summary[J]. Am J Respir Crit CareMed,2001,163(5):1256-1276.
2. 中华医学会呼吸病学分会慢性阻塞性肺疾病学组. 慢性阻塞性肺疾病诊治指南[J]. 中华结核和呼吸杂志, 2002,25(8):453-460.
3. 胡国萍. 经面罩无创机械通气治疗慢性阻塞性肺疾病合并重症呼吸衰竭[J].中国呼吸与危重监护杂志,2004,3(3):176.
4. 钮善福.进一步拓宽面罩机械通气的临床适应证[J].中国呼吸与危重监护杂志, 2002,1(4):197-198.
5. 梁建忠,李小玲,潘陶涛,等.无创正压通气治疗慢性阻塞性肺疾病并严重呼吸衰竭的临床研究[J].第四军医大学学报,2007,28(22):2079-2081.
6. ATS. International Consensus Conferences in Intensive Care Medicine:noninvasive positive pressure ventilation in acute respiratory failure[J]. Am J Respir Crit Care Med,2001,163(1):283-291.

West China Medical Journal

Clinical Investigation of Non-Invasive Positive Pressure Ventilation in Treatment for Patients with Chronic Obstructive Pulmonary Disease and Severe Respiratory Failure

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