摘要
目的探讨无创通气在慢性阻塞性肺疾病急性加重期(COPD-AE)并呼吸衰竭的临床应用。方法选择COPD-AE并呼吸衰竭患者110例。根据血气分析指标分为A组、B组、C组,在常规治疗基础上行无创通气,观察患者上机前、上机后1小时、24小时、72小时的血气分析指标、氧合指数变化、呼吸机参数设置和上机时间。结果总有效率98%,三组患者治疗前后血气分析指标、氧合指数比较差异有非常显著性(P<0.01);治疗72小时后,B组、C两组PaCO2与A组比较明显偏高(P<0.01),pH值和氧合指数比较无差异(P>0.05);呼吸机参数设置:三组呼气压值均为4cmH2O,B组与A组比较、C组与A组、B组比较吸气压值均明显偏高(P<0.01)。B组与A组比较、C组与A组、B组比较每日上机时间和上机时间总和明显延长(P<0.01)。C组中除2例无效外,均治疗有效出院。结论无创通气治疗COPD-AE并呼吸衰竭疗效显著,对不同程度的呼吸衰竭患者在呼吸机参数设置上应区别对待。
Objective To study the clinical use of non-invasive ventilation on the patients with acute exacerbation of COPD（COPD-AE）.Method 110 cases of COPD with acute respiratory failure were chosen and divided into three groups according to the blood gas analysis when inclusion.Tha patients were divided group A,group B and group C according to the patient＇s blood gas.The patients were treated with non-invasive ventilation based on the conventional therapy.We observed the blood gas analysis, oxygenation index before mechanical ventilation and 1,24,72 hours after mechanical ventilation,the setting of ventilators,and the duration of mechanical ventilation.Results The total effective power were 98%.The improvement of the blood gas analysis and the oxygenation index before and after treatment was significant.The PaCO2 of group B and group C was significantly higher than that of group A 72 hours after mechanical ventilation（P〈0.01）.But the pH and the oxygenation were not significant different among three groups 72 hours after mechanical ventilation （P〉0.05）.The EPAP of three groups were 4 cmH2O.The IPAP of group B was significantly higher than that of group A （P〈0.01）.The IPAP of group C was significantly higher than that of group A and group B（P〈0.01）.The duration of mechanical ventilation everyday and the total duration of mechanical ventilation in group B were significantly longer than those in group A（P〈0.01）,and those in group C was significantly longer than those in group A and group B.The patients except two of group C were cured and discharged.Conclusion The significant effect can be gotten with non-invasive mechanical ventilation on the patients of COPD-AE.The different setting of ventilator should be used in the patients suffering from the different degree of COPD-AE.
出处
《临床内科杂志》
CAS
2008年第3期177-179,共3页
Journal of Clinical Internal Medicine
