摘要
目的对慢性阻塞性肺病(Chronic obstructive pulmonary disease,COPD)稳定期合并型呼吸衰竭患者家庭使用无创机械通气的情况,确定其临床意义并分析存在的问题。方法重度COPD合并型呼吸衰竭的稳定期患者使用双水平气道正压呼吸机行面罩通气,与长期氧疗患者比较在随访的1年中的急性加重次数、住院次数,以及6分钟行走距离、圣.乔治呼吸量表评分、血气指标和肺功能参数的变化。结果COPD稳定期患者家庭使用无创通气后,PaCO2和圣.乔治呼吸评分降低,pH、PaO2和6分钟行走距离增加;与氧疗组相比,急性加重次数及住院次数减少,PaCO2和圣.乔治呼吸评分也明显改善。每天坚持使用无创通气12h以上的患者效果更为明显。结论COPD稳定期合并型呼吸衰竭患者家庭使用无创通气优势明显,但存在着消毒不好,因缺乏医疗专业知识,可能耽误病情等问题,需要加强巡诊和随访服务,指导排痰方面的康复治疗和呼吸锻炼。
Objective To ascertain the clinic value of home non-invasive mechanical ventilation in patients with stable-phase chronic obstructive pulmonary disease （COPD） and type Ⅱ respiratory failure and to analyse underlying problems through follow-up visit within one year. Methods Stable COPD patients complicated by type II respiratory failure received bi-level positive airway pressure ventilation through the face mask. The frequency of acute exacerbation and admission times, the changes of 6-min walk distance, St. George＇s respiratory questionnaire score, blood gas analysis, and pulmonary function results were compared in these patients with those received long term oxygen therapy. Results After one year home non-invasive ventilation （NIV）, PaCO2 and St. George＇s respiratory questionnaire score were decreased, while pH, PaO2 and 6-min walk distance were increased. Compared with patients received long term＇ oxygen therapy, PaCO2 and St. George＇s respiratory questionnaire score were greatly ameliorated, and the frequency of acute exacerbation and admission times declined. Conclusion There are several advantages for stable COPD patients treated by home non-invasive mechanical ventilation. But some problems exist, such as hardly offering urgent medical care because of poor sterilization and shortage of medical expertise. Regular follow-up, guidelines on rehabilitation and respiratory training are necessary.
出处
《西部医学》
2007年第5期797-799,共3页
Medical Journal of West China
关键词
慢性阻塞性肺病
肺疾病
无创机械通气
呼吸衰竭
Chronic obstructive pulmonary disease
Pulmonary disease
Non-invasive mechanical ventilation
Respiratory failure
