拒绝气管插管的AECOPD 并严重呼吸性酸中毒及意识障碍患者行无创正压通气治疗的疗效分析

姚睿

（陕西省安康市汉滨区第一医院内科，陕西 安康，725000）

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摘要：

目的 探讨无创正压通气治疗慢性阻塞性肺疾病急性加重（AECOPD）并严重呼吸性酸中毒而拒绝气管插管患者的临床效果。方法 选取我院收治的210 例AECOPD 并严重呼吸性酸中毒及意识障碍患者进行研究，患者均行无创正压通气治疗， 对其治疗效果进行观察。结果 随着治疗时间的延长，本组患者的pH、PaCO2 与PaO2/FiO2 水平均明显升高（P<0.05）；患者PaCO2 水平明显降低（P<0.05）。患者治疗总有效率为86.2%，平均总通气时间为（117.8±4.3）h，平均日通气时间为（20.6±3.9）h。结论 对拒绝气管插管的AECOPD 并严重呼吸性酸中毒患者实施无创正压通气治疗，效果显著，有利于提高治疗成功率，可在临床 上推广应用。

关键词：无创正压通气；慢性阻塞性肺疾病急性加重；呼吸性酸中毒

中图分类号：R563.9文献标志码：A文章编号：2096-1413(2017)34-0059-02

Effect of noninvasive positive pressure ventilation in patients with AECOPD who refused tracheal intubation and complicated with severe respiratory acidosis and unconsciousness
YAO Rui
(Internal Medicine Department, the First Hospital of Hanbin District, Ankang 725000, China)

ABSTRACT: Objective To investigate the effect of noninvasive positive pressure ventilation in treatment of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) who refused tracheal intubation and complicted with severe respiratory acidosis and unconsciousness. Methods Two hundred and ten cases of patients with AECOPD complicted with severe respiratory acidosis and unconsciousness admitted in our hospital were studied. The patients all underwent noninvasive positive pressure ventilation treatment, the treatment effect was observed. Results With the prolong of treatment time, the levels of pH, PaO2, PaO2/FiO2 significantly increased (P <0.05); the PaCO2 level significantly decreased (P<0.05). The total effective rate of patients was 86.2%, the average time of total ventilation was (117.8±4.3) h, the average daily ventilation time was (20.6±3.9) h. Conclusion For patients with AECOPD who refused tracheal intubation complicted with severe respiratory acidosis and unconsciousness, noninvasive positive pressure ventilation has exact effect, it can effectively improve the success rate of treatment, which can be widely used in clinical practice
KEYWORDS: noninvasive positive pressure ventilation; acute exacerbation of chronic obstructive pulmonary disease; respiratory acidosis

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