【摘要】 目的 探讨应用无创机械通气治疗慢性阻塞性肺疾病 (COPD)合并失代偿期Ⅱ型呼吸衰竭的疗效。方法 将COPD合并失代偿期Ⅱ型呼吸衰竭患者随机平行分为治疗组和对照组，各34例。对照组给予抗感染、支气管扩张剂、止咳化痰、雾化吸入及支持治疗，治疗组在以上治疗的基础上给予无创机械通气模式。无创机械通气模式：BiPAP，吸气压8～25cmH2O，呼气压3～6cmH2O，氧浓度40%，在保持动脉血氧饱和度在90%以上，再进行调节，通气时间1周，每天2次，每次4h。结果 无创机械通气对提高PaO2和降低PaCO2与对照组比较差异有显著性(P<0.05)。结论 双水平气道正压(BiPAP)无创机械通气对COPD合并失代偿期Ⅱ型呼吸衰竭的治疗效果好，可减少气管插管和气管切开的使用，减少患者痛苦，对提高PaO2和降低PaCO2有显著作用。

    【关键词】 机械通气；双水平气道正压；慢性阻塞性肺疾病；呼吸衰竭

    Non-invasive mechanic ventilation in chronic obstructive pulmonary disease patients with type-Ⅱ respiratory faliure

    HONG Song，SHUI Hong，CHEN Yan-qi.Beijing Hospital,Beijing,100730,China

    【Abstract】 Objective To evaluate the efficacy of noninvasive mechanical ventilation in the treatment of COPD patients with type Ⅱ respiratory failure.Methods 68 cases were divided into two groups:noninvasive mechanic ventilation and control.Cases in control were given antiinfection,eliminating phlegm,relieving asthma,hormone and supply treatment cases in treatment group were treated with Bilevel positive airway pressure (BiPAP) ventilation in addition to above routine treatment.Respiratory treatment parameter was as follow.S/T model,IPAP 8～25 cmH2O,EPAP 3～6 cmH2O,twice a day and 4 hours per time,each course lasted for 7 days.Results After 7 days,PaO2 and PaCO2 changed significantly more in the treatment group than that in the control (P<0.05).Conclusion Noninvasive mechanical ventilation as an auxiliary treatment is definitely valuable for COPD patients with type-II respiratory failure. ......