【摘要】 目的 评价双水平正压通气(BiPAP)呼吸机无创机械通气治疗老年慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭的临床疗效。方法 87例60岁以上COPD合并Ⅱ型呼吸衰竭患者，分为治疗组41例和对照组46例，两组均给予常规药物治疗，治疗组同时给予BiPAP呼吸机进行无创机械通气治疗。结果 BiPAP耐受良好的26例患者，治疗后其动脉血氧分压(PaO2)和二氧化碳分压(PaCO2)较治疗前明显改善(P<0.01)；与对照组比较，平均住院天数缩短(P<0.05)、血气改善时间提前(P<0.01)、血气改善程度更好(P<0.05)；BiPAP治疗还可以减慢呼吸和心率的频率(P<0.01)，而对患者血压水平无明显影响(P>0.05)；且无1例发生腹胀、皮肤压伤、气压伤或呼吸机相关肺炎。结论 经鼻罩BiPAP呼吸机无创机械通气是治疗老年COPD合并Ⅱ型呼吸衰竭的一种安全有效的方法。

    【关键词】 BiPAP呼吸机；COPD；Ⅱ型呼吸衰竭；无创机械通气；老年

    The observation of clinical efficacy of BiPAP non-invasive mechanical ventilation treatment on aged COPD combined with respiratory failure type Ⅱ

    XU Jiang-xiang，LIU Zhi-qiang，WANG Xia，et al.No1 Department，the First People’s Hospital of Jiujang，Jiangxi 332000，China

    【Abstract】 Objective To evaluate the clinical efficacy of non-invasive mechanical ventilation on chronic obstructive pulmonary disease (COPD) combined with respiratory failure type two by bi-positive airway pressure (BiPAP) breathing machine.Methods 87 patients older than 60 years suffered from COPD combined with respiratory failure type two were enrolled and divided into treatment group (41 cases) and control group (46 cases).Routine pharmaceutical intervention was adopted in both groups while non-invasive mechanical ventilation by BiPAP breathing machine was given in the patients of treatment group.Results Arterial partial pressure of oxygen and carbon dioxide were significantly improved after treatment in 26 patients well-tolerated with BiPAP breathing machine.Comparing with control group ......