【摘要】 目的研究应用非侵入性呼吸机治疗老年人COPD急性加重期的临床价值。方法对24名老年COPD急性加重期患者应用非侵入性鼻面罩双水平气道正压通气(BiPAP)治疗,观察治疗前后呼吸频率、潮气量Vt、血PaO2、PaCO2、SaO2、pH以及心率、平均动脉压(MAP)、呼吸窘迫等指标的变化。结果患者在24h的鼻面罩BiPAP治疗中,呼吸频率从25±3次/分降低到16±3次/分(P<0.01),潮气量Vt从0.32±0.05升增加到0.56±0.06升(P<0.01),PaO2从54±5mmHg提高到96±11mmHg(P<0.01),PaCO2从68±8mmHg降低到47±6mmHg(P<0.01),pH从7.28±0.05升高到7.34±0.03P<0.01,呼吸窘迫明显改善P<0.01,心率从108±11下降到93±12(P<0.05)、血压无明显改变(P>0.05)。结论对老年COPD急性加重期患者应用非侵入性口鼻面罩BiPAP治疗是安全有效的,值得在临床推广应用。更多还原

【Abstract】 Objective To evaluate the clinical applicatio ns of noninvasive ventilation in the treatment of COPD exacer-bations in the elderly patients.Methods Twenty -four elderly patients with COPD exacerbations were treated with bilevel positive airway pressure(BiPAP)by noninvasive nasal(face)mask.Before and after ventilatory s upport,the breathing rate,Vt,PaO 2 ,PaCO 2 ,SaO 2 ,pH,heart rate and MAP were recorded.Results During and after 24hours treatment,the breathing rate,heart rate,Vt ,PaO 2 ,PaCO 2 and pH were significantly improved(P<0.01).The dyspnea was markedly relieved(P<0.01).The MAP was not changed very much(P>0.05).Conclusions The noninvasive nasal(face)mask BiPAP is a kind of safe and effective method in the treatment of COPD exacerbations in the elderly patients.It can be recommended for clinical use.[更多还原