摘要
目的 探讨鼻塞法低负压吸出技术 (NASPI)对COPD急性期并Ⅱ型呼吸衰竭 (呼衰 )患者二氧化碳的清除作用及其对病情的影响。方法 4 0例COPD急性期并Ⅱ型呼衰患者分为NASPI治疗组和呼吸兴奋剂治疗 (对照 )组 ,每组 2 0例。 4 0例均常规给予 2 5 %氧疗、抗感染、茶碱解痉和对症支持治疗。NASPI组加用鼻塞法清肺仪中档 (以 32 0～ 4 0 0Pa的负压每分钟吸出约 15 0 0ml气体的速度 )治疗 2h ,期间氧疗浓度改为 2 9% ;对照组则加用可拉明 2 .5 μg/min和洛贝林 2 0 μg/min持续静脉点滴 2 4h ,治疗前后均抽动脉血进行血气分析 ,并记录症状。结果 NASPI可明显降低患者动脉血二氧化碳分压 (PaCO2 )水平 (P <0 .0 0 1) ,NASPI对二氧化碳的清除效果优于呼吸兴奋剂 ;而且NASPI治疗后患者咳痰增多且易咳出。NASPI加氧疗可使PaO2 和SaO2 显著升高 (分别为P <0 .0 1)。NASPI可使PH值有所升高但不显著 (P >0 .0 5 )。NASPI治疗时部分患者感咽喉部干燥不适。结论 NASPI能有效地降低COPD急性期Ⅱ型呼衰患者的PaCO2 ,并使患者咳痰增多且易咳出 ,方法简便、安全、实用。
Objective: To evaluate the effects of aspiration with low negative pressur by nasal obstruction (NASPI) on elimination of CO 2 and influence on patient's condition in patients with type Ⅱ respiratory failure in acute period of COPD. Methods: Forty type Ⅱ respiratory failure cases in acute period of COPD were averagely divided into two groups randomly;the NASPI group and the control group ,which were all treated by 25% oxygen, antibioltic and elixophylline. Using NASPI device with negative pressur of 320～400 Pa, about 1500 ml/min of aspiration of air on the NASPI group for 2 hours, with 29% oxygen therapy by another nasal obstruction, and the patients were asked to close their mouths as possible as they could during NASPI; using Coramine 2.5μg/min and Lobeline 20μg/min by vein drop on the control group for 24 hours. Arterial blood gas analysis and symptom were observed at pretreatment and post-treatment .Results: NASPI significantly decreased PaCO 2 level ( P <0.001). The elimination of CO 2 of NASPI was superior to that of respiratory center stimulant. And after NASPI, patients easily cough up more phlegms. While adding to oxygen therapy, NASPI significantly increased PaO 2 and SaO 2. NASPI increased PH a little but not significant. At NASPI time, some patients felt laryngopharynx dry . Conclusions: NASPI is a simple, economical, safe and practical method, which can effectively decrease PaCO 2 of patients with type Ⅱ respiratory failure in acute period of COPD; and after NASPI, patients cough up more phlegm easily.
出处
《中国现代医学杂志》
CAS
CSCD
2004年第7期50-52,共3页
China Journal of Modern Medicine
关键词
鼻塞法低负压吸出
COPD急性期
Ⅱ型呼吸衰竭
aspiration with low ngative pessur by nasal obstruction
acute period of COPD
type Ⅱ respiratory failure
