Research On The Effect Of Noninvasive Positive Pressure Ventilation (NIPPV) When Treating Acute Exacerbation Of Chronic Obstructive Pulmonary Diseases (AECOPD) With Type Ⅱ Repiratory Failure

Objective1. To research the changes and clinic significance in the level of blood lactate values and blood gas analysis(PH, PaO2, PCO2) in Noninvasive positive pressure ventilation (NIPPV) in treating acute exacerbation of COPD with type II respiratory failure.2. To observe the changes of heart rate and breath rate in NIPPV in treating acute exacerbation of COPD with typeⅡrespiratory failure and further to assess the effect of NIPPV in treating acute exacerbation of COPD with typeⅡrespiratory failure.3. Clinical curative effect was comparing when using different parameters of NIPPV in treating acute exacerbation of COPD with typeⅢrespiratory failure.Materials and Methods1. Object choice Exactly choose 120 patients with acute exacerbation of COPD with typeⅡrespiratory failure who were enrolled as treated group from January 2008 to December 2010 in our Department of Respiratory based on the criterion of bringing and excluding.2. Grouping design2.1 Grouping methods The selected 120 patients with acute exacerbation of COPD standard with typeⅡrespiratory failure were randomly divided into control group,60 patients; treatment group,60 patients, treatment group were randomly divided into A group and B group.2.2 Treatment methods Control group with conventional therapy methods, including oxygen, infection control, antispasmodic asthma, cough sputum interest, correct electrolyte imbalance and nutritional support therapy; treatment group with conventional therapy and noninvasive intermittent positive pressure ventilation treatment. A group was different wih B group in using parameters of NIPPV.3. Statistics analysis To make statistic analysis by SPSS13.0 stat soft, the two overall component ratios are checked by x2 . The measurement are showed by average number±standard deviation, and the comparison are examined by t-test, when P<0.05, the comparison is statistically significant.Results 1. The general comparision of the two groups before treatment:liver function (ALT, AST),renal function (BUN, Cr) and fasting blood glucose was not significantiy significant(P<0.05).2. Two groups of results of blood gas analysis and blood lactate compared:the comparison of the level of PH, PaO2, PaCO2 and blood lactate of the two groups before treatment was not significantiy different (P> 0.05).24 hours later after treatment, the level of PH,PaO2, PaCO2 and blood lactate of two groups was significantiy different (P<0.05). And with the further to compare the interpolation of PH, PaO2, PaCO2 and blood lactate between the control group and treatment group after treatment, the difference between the two groups has statistical significance(P <0.05)3. Two groups of observations of clinical symptoms and signs:the level of RR and HR after treatment in two groups was significantiy different (P<0.05), and with the further to compare the interpolation of RR and HR between the control group and treatment group after treatment, the difference between the two groups has statistical significance(P<0.001)。4. Curative effect comparison of A and B groups:the comparison of the level of PH, PaO2, PaCO2, blood lactate, RR and HR of the two groups before treatment was not significantiy different (P>0.05).24 hours later after treatment, compare the interpolation of PaO2, PaCO2,blood lactate ,RR and HR between the A group and B group after treatment, the difference between the two groups has statistical significance(P<0.05)Conclusion1. Noninvasive positive pressure ventilation can improve the level of blood lactate with acute exacerbation of COPD with typeⅡrespiratory failture.2. Noninvasive positive pressure ventilation is beneficial to the recovery of the disease through improving the level of PH, PaO2, and the decline of PaCO2 and better the patients breath rate and heart rate.3. Noninvasive positive pressure ventilation is one of effective methods in the treatment of patients with acute exacerbation of COPD with typeⅡrespiratory failture.4. Clinical curative effect was different when using different parameters of NIPPV in treating acute exacerbation of COPD with typeⅡrespiratory failure.