摘要目的:探讨双水平气道正压(BiPAP)通气和持续气道正压(CPAP)通气对呼吸内科监护病房(RCU)急性呼吸窘迫综合征患者的影响。方法:选取2017年9月至2019年9月鹤壁市人民医院RCU收治的125例急性呼吸窘迫综合征患者，男56例，女69例，年龄(63.46±4.72)岁，年龄范围为50～80岁，采用随机简单化法将其随机分为BiPAP组( n＝63)和CPAP组( n＝62)。BiPAP组予以BiPAP通气治疗，CPAP组给予CPAP通气治疗，观察两组患者血气指标[动脉血氧饱和度(SpO 2)、动脉血氧分压(PaO 2)、动脉血二氧化碳分压(PaCO 2)]、RCU住院时间、机械通气时间、气管插管率、RCU病死率。 结果:治疗后，BiPAP组治疗后的SpO 2[(93.38±1.45)mmHg，1 mmHg＝0.133 kPa]、PaO 2[(95.84±2.23)mmHg]高于CPAP组[(87.63±2.64)mmHg、(91.34±1.96)mmHg]，PaCO 2[(43.35±2.26)mmHg]低于CPAP组[(50.45±2.39)mmHg]，差异有统计学意义( P<0.05)。BiPAP组RCU住院时间[(19.54±5.10)d]、机械通气时间[(10.43±2.52)d]、气管插管率[17.5%(11/63)]均低于CPAP组[(23.43±4.32)d、(18.87±3.52)d、33.9%(21/62)]，差异有统计学意义( P<0.05)。BiPAP组RCU病死率[30.2%(19/63)]与CPAP组[30.7%(19/62)]比较，差异无统计学意义( P>0.05)。 结论:BiPAP应用于RCU急性呼吸窘迫综合征患者可有效改善血气指标，促进患者恢复，从而有效缩短通气时间，降低气管插管率。

abstractsObjective:To investigate the effects of bi-level positive airway pressure(BiPAP)and continuous positive airway pressure(CPAP)on patients with acute respiratory distress syndrome(ARDS)in respiratory care unit(RCU).Methods:A retrospective study was performed on 125 cases of patients with ARDS who were admitted in RCU from September 2017 to September 2019.The patients were randomly divided into the BiPAP group( n=63)and CPAP group( n=62), with 56 males and 69 females, aged(63.46±4.72)years old, ranging from 50 to 80 years old.The BiPAP group of patients received BiPAP ventilation therapy, and the CPAP group of patients received CPAP ventilation therapy.Blood gas indexes[SpO 2, PaO 2, PaCO 2], RCU hospitalization, mechanical ventilation, endotracheal intubation rate, and RCU mortality were observed in the two groups. Results:After treatment, SpO 2[(93.38±1.45)mmHg, 1 mmHg=0.133 kPa]and PaO 2[(95.84±2.23)mmHg]in the BiPAP group were higher than those in the CPAP group[(87.63±2.64)mmHg, (91.34±1.96)mmHg], and PaCO 2[(43.35±2.26)mmHg]were lower than those in the CPAP group[(50.45±2.39)mmHg], with statistically significant differences( P<0.05). In the BiPAP group, RCU hospitalization time[(19.54±5.10)days], mechanical ventilation time[(10.43±2.52)days]and endotracheal intubation rate[17.5%(11/63)]were all lower than those in the CPAP group[(23.43±4.32)days, (18.87±3.52)days, 33.9%(21/62)], ( P<0.05). There was no significant difference in RCU case fatality rate between the BiPAP group[30.2%(19/63)]and the CPAP group[30.7%(19/62)], ( P<0.05). Conclusion:The application of BiPAP in RCU patients with acute respiratory distress syndrome can effectively improve the blood gas index, promote the recovery of patients, and thus effectively shorten the ventilation time and reduce the rate of tracheal intubation.