Zhang Wei-bing, Wang Xin-yan, Tian Xiao-yan, Zhang Hui, Wang Zhi-peng, Gao Yu-yan
The Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang, China.
Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2008 Oct;20(10):601-3.
To evaluate the value of noninvasive positive-pressure ventilation (NIPPV) in treatment of patients with chronic obstruction pulmonary disease (COPD) combined with type II respiratory failure (RF).
From June 15th, 2002 to June 15th, 2006, there were 351 inpatients with COPD combined with type II RF. Those treated with NIPPV were categorized as treatment group; those who were not treated by NIPPV served as control group. All patients were divided into four subgroups according to results of blood gas analysis as follows. Mild RF group: 50 mm Hg < or = arterial partial pressure of carbon dioxide (PaCO2) < or = 65 mm Hg, 1 mm Hg=0.133 kPa; medium RF group: 66 mm Hg < or = PaCO2 < or = 80 mmHg; severe RF group: 81 mm Hg < or = PaCO2 < or = 95 mm Hg; extremely severe RF group: > or = 96 mm Hg. NIPPV was used in treatment group on top of conventional treatment. Values of blood gas analysis, length of stay, cost of hospitalization, rate of cannulation and fatality rate were observed in all groups before treatment and after treatment.
After being treated with NIPPV, all patients with COPD combined with type II RF in different degrees, arterial partial pressure of oxygen (PaO2) were raised in different degrees, and PaCO2 were all lowered in different degrees. Blood pH, PaO2 and PaCO2 showed statistically significant difference between treatment group and control group in severe and extremely severe RF patients (all P < 0.05). The length of stay of patients with RF in different degrees, was shortened obviously, also the cost of hospitalization, rate of cannulation and fatality rate were all significantly reduced in treatment group. In contrast to mild, medium RF patients, rate of cannulation and fatality rate were increased in extremely severe RF group (all P < 0.05).
NIPPV is beneficial to COPD combined with type II RF in different degrees.
评估无创正压通气（NIPPV）在治疗慢性阻塞性肺疾病（COPD）合并Ⅱ型呼吸衰竭（RF）患者中的价值。
2002年6月15日至2006年6月15日，351例COPD合并Ⅱ型RF住院患者。接受NIPPV治疗的患者分为治疗组；未接受NIPPV治疗的患者作为对照组。所有患者根据血气分析结果分为以下四个亚组。轻度RF组：动脉血二氧化碳分压（PaCO2）50 mmHg≤或<65 mmHg，1 mmHg = 0.133 kPa；中度RF组：66 mmHg≤或<80 mmHg；重度RF组：81 mmHg≤或<95 mmHg；极重度RF组：≥96 mmHg。治疗组在常规治疗基础上使用NIPPV。观察所有组治疗前后的血气分析值、住院时间、住院费用、插管率和死亡率。
接受NIPPV治疗后，不同程度的COPD合并Ⅱ型RF患者，动脉血氧分压（PaO2）均有不同程度升高，PaCO2均有不同程度降低。重度和极重度RF患者中，治疗组与对照组的血pH、PaO2和PaCO2差异有统计学意义（均P<0.05）。不同程度RF患者的住院时间明显缩短，治疗组的住院费用、插管率和死亡率也均显著降低。与轻度、中度RF患者相比，极重度RF组的插管率和死亡率升高（均P<0.05）。
NIPPV对不同程度的COPD合并Ⅱ型RF有益。
