不同通气方式治疗急诊科慢性阻塞性肺疾病并Ⅱ型呼吸衰竭的疗效观察

张建鹏，唐茜

（陕西省渭南市第一医院，陕西 渭南，714000）

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摘要：

目的 探讨不同通气方式治疗急诊科慢性阻塞性肺疾病（COPD）并域型呼吸衰竭的疗效。方法 选择2013年10月至2016年10月于我院急诊科进行急救治疗的COPD并域型呼吸衰竭患者64例，根据通气方式将其分为有创组（32例）与无创组（32例）。无创组患者采用无创呼吸机通气治疗，有创组采用气管切开或气管插管连接呼吸机通气治疗。观察对比两组治疗效果。结果 治疗24 h 时，两组血气指标较治疗前明显改善（P<0.05），有创组动脉血氧分压、动脉血氧饱和度高于无创组（P<0.05），二氧化碳分压低于无创组（P<0.05）。两组好转、死亡及放弃率比较，差异无统计学意义（P>0.05）。治疗24h 时，两组血清脑钠肽水平均降低，且有创组血清脑钠肽水平低于无创组（P<0.05）。结论有创通气可以有效改善急诊COPD并Ⅱ型呼吸衰竭患者的通气功能，纠正脑钠肽水平。

关键词：有创正压通气；无创正压通气；慢性阻塞性肺疾病；Ⅱ型呼吸衰竭

中图分类号：R563.8文献标志码：A文章编号：2096-1413(2017)28-0041-02

Efficacy observation of different ventilation in the treatment of chronic obstructive pulmonary disease with type Ⅱrespiratory failure in emergency department
ZHANG Jian-peng, TANG Qian
(the First Hospital of Weinan, Weinan 714000, China)

ABSTRACT: Objective To study the clinical effects of different ventilation methods on chronic obstructive pulmonary disease (COPD) with type Ⅱ respiratory failure in emergency department. Methods A total of 64 cases of patients with COPD with Ⅱ type respiratory failure admitted in emergency department of our hospital were enrolled, and divided into invasive group (32 cases) and noninvasive group (32 cases) according to ventilation methods. The noninvasive group was treated with noninvasive ventilator ventilation, while the invasive group was treated with tracheotomy or tracheal intubation connected with ventilator ventilation. The clinical effects were compared between the two groups. Results At 24 h of treatment, the blood gas indexes significantly improved in both groups (P<0.05); the arterial oxygen pressure, arterial oxygen saturation of the invasive group were significantly higher than those of the noninvasive group (P<0.05), and the partial pressure of carbon dioxide of the invasive group was significantly lower than that of the noninvasive group (P<0.05). There were no significant differences in the proportions of improvement, death and abandonment between the two groups (P>0.05). At 24 h of treatment, the levels of serum brain natriuretic peptide significantly reduced in both groups (P<0.05), and that in the invasive group was lower than the noninvasive group (P <0.05). Conclusion Invasive ventilation can improve the ventilatory function of patients with COPD with type Ⅱ respiratory failure and correct the levels of brain natriuretic peptides.

KEYWORDS: invasive positive pressure ventilation; noninvasive positive pressure ventilation; chronic obstructive pulmonary disease; type Ⅱ respiratory failure

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