Clinical Observation Of Noninvasive Positive Pressure Ventilation In The Treatment Of AECOPD With TypeⅡRespiratory Failure

Objective: To investigate the effect of noninvasive positive pressure ventilation NIPPV in treatment of chronic obstructive pulmonary disease with acute exacerbation of respiratory failure, aim to provide a reference for find an effective way in the clinical treatment of chronic obstructive pulmonary disease with acute exacerbation of respiratory failure. Methods: From April to 2014 January 2015 in our hospital chronic obstructive pulmonary disease with acute exacerbation of respiratory failure in 80 patient as an object of observation groups were treated antiinfectious, antispasmodic, expectorant, correct electrolyte imbalance and symptomatic and supportive cure. Treatment group while applying Bi PAP Symchrony ventilator, through t-he nose and mouth mask for NIPPV treatment; control group was given low flow nasal catheter ventilation therapy. Observed and compared: ⑴The clinical efficacy of two groups of patients; ⑵Two groups of patients before and after ventilation 48 hours,ve-ntilation therapy at the end of RR, HR, Pa CO2, Pa O2, p H changes. ⑶Two groups of patient intubation and mechanical ventilation,mortality, average length of stay and complications that occur during treatment. Results: End of treatment, patients treated with RR, Pa CO2, Pa O2, p H changed than before treatment, aeration after48 h after ventilation improved significantly within the group, RR(t=39.39, P<0.05), HR(t=39.83, P<0.05), Sa O2(t=﹣28.12, P<0.05), PH(t=﹣11.71, P<0.05), Pa O2(t=﹣20.69, P<0.05), Pa CO2(t=24.08, P<0.05), the difference was significant(P<0.05). And in patients treated with RR, Pa CO2, Pa O2, p H compared with the control group improved more significantly between the two groups, Sa O2(t=12.39, P<0.05), Pa O2(t=5.69, P<0.05), Pa CO2(t=﹣10.96, P<0.05), RR(Z=﹣5.79, P<0.05), HR(Z=﹣5.91, P<0.05), PH(Z=﹣5.31, P<0.05), the difference was significant(P<0.05). Patients treated with intubation and mechanical ventilation rate of 5.0%, was significantly lower than the control g-roup, he treatment group patients had a mean hospital stay was(11.4±3.5)d, was significantly shorter than the control group, and the difference was significant(P<0.05). After treatment,the total effective rate of the treatment group was 90.0%, was significantly higher than that of the control group(57.5%)(P<0.05). Conclusion: Noninvasive positive pressure ventilation in chronic obstructive pulmonary disease with acute exacerbation of respiratory failure can improve clinical out comes, improve the patient’s oxygen partial pressure and oxygen saturation, shorter hospital stays. But in the course of treatment, doctors should prevent and promptly deal with the adverse reactions. This should be popularized and appled.