高强度无创正压通气的研究进展
Research Progress of High-Intensity Non-Invasive Positive Pressure Ventilation
摘要: 无创正压通气(Noninvasive Positive Pressure Ventilation, NPPV)作为急、慢性呼吸衰竭的重要干预手段，近年来在各类急性、慢性呼吸衰竭疾病中均取得了显著疗效。然而，传统NPPV在部分重症患者中未能充分改善通气不足与CO2潴留情况，尤其在严重高碳酸血症、呼吸驱动低下及夜间低通气患者中治疗效果有限。近年来，高强度无创正压通气(High-Intensity Non-Invasive Positive Pressure Ventilation, HI-NPPV)作为一种新的策略应运而生。部分研究发现，HI-NPPV能通过提高吸气压力和潮气量，迅速纠正高碳酸血症，降低PaCO2浓度，减少呼吸机相关并发症，改善患者生存率。本综述整理了近年来HI-NPPV的相关研究进程，以及其在各类疾病中(包括慢阻肺稳定期、急性加重期、呼吸衰竭及急性心源性肺水肿等)中的应用进展。
Abstract: Noninvasive Positive Pressure Ventilation (NPPV) has emerged as a crucial intervention for acute and chronic respiratory failure, demonstrating significant efficacy in various related conditions in recent years. However, conventional NPPV often fails to adequately address hypoventilation and CO2 retention in some critically ill patients, showing limited effectiveness particularly in cases of severe hypercapnia, reduced respiratory drive, and nocturnal hypoventilation. In recent years, High-Intensity Non-Invasive Positive Pressure Ventilation (HI-NPPV) has emerged as an innovative strategy. Some studies have found that HI-NPPV, by increasing inspiratory pressure and tidal volume, can rapidly correct hypercapnia, reduce PaCO2 levels, decrease ventilator-associated complications, and improve patient survival rates. This review consolidates relevant research on HI-NPPV and its application progress across various diseases, including stable and acute exacerbation phases of Chronic Obstructive Pulmonary Disease, respiratory failure, and acute cardiogenic pulmonary edema.
文章引用：陈晓蝶, 王晓龙. 高强度无创正压通气的研究进展[J]. 临床医学进展, 2025, 15(11): 791-798. https://doi.org/10.12677/acm.2025.15113162

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