无创双水平呼吸道正压通气联合呼吸兴奋剂在慢性阻塞性肺疾病并发肺性脑病中的应用探讨

王继芹; 顾薇; 韩冰

无创双水平呼吸道正压通气联合呼吸兴奋剂在慢性阻塞性肺疾病并发肺性脑病中的应用探讨

Investigation of noninvasive bi-level positive airway pressure ventilation combined with respiratory stimulant treatment of chronic obstructive pulmonary disease with pulmonary encephalopathy

摘要

摘要: 目的:探讨慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者呼吸衰竭急性加重并发肺性脑病时给予无创双水平呼吸道正压通气(BiPAP)同时联用呼吸兴奋剂治疗的疗效。方法:80例COPD并发肺性脑病患者随机均分为单纯通气组和联用呼吸兴奋剂组,观察2组治疗前后一般情况及血气分析变化。结果:与单用BiPAP通气组比较,联用呼吸兴奋剂组病情恢复快,呼吸、心率、动脉血pH、动脉血氧分压和动脉血二氧化碳分压的改善均优于单纯通气组(P<0.05~P<0.01)。2组患者好转率差异无统计学意义(P>0.05)。结论:对于并发肺性脑病的COPD患者,BiPAP无创通气联合呼吸兴奋剂治疗是一种无创有效的措施,可减少气管插管或气管切开以及相应并发症。

Abstract: Objective: To investigate the therapeutic effect of noninvasive bi-level positive airway pressure (BiPAP) ventilation combined with respiratory stimulant treatment of patients with chronic obstructive pulmonary disease (COPD) acute aggravation complicated with pulmonary encephalopathy.Methods: Eighty patients with COPD complicated with pulmonary encephalopathy were divided into BiPAP group simply and BiPAP combined with repiratory stimulant group randomly.The general condition and changes of blood gas analysis in the two groups were observed.Results: Compared with BiPAP group,patients in combination treatment group showed more rapid recovery,these parameters including breathing,heart rate,arterial blood pH,PaO₂ and PaCO₂ improvements were better than in simple ventilation group (P<0.05~P<0.01).The efficacy rate in the two groups was no statistical difference (P>0.05).Conclusions: In COPD patients complicated with pulmonary encephalopathy,BiPAP combined with respiratory stimulant is an effective and noninvasive method which can reduce some side effects such as tracheal intubation or tracheotomy.

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