无创正压通气治疗AECOPD合并Ⅱ型呼吸衰竭的临床分析(1)
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[摘要] 目的 回顾总结无创正压通气(NPPV)对慢性阻塞性肺疾病急性加重期(AECOPD)合并Ⅱ型呼吸衰竭的疗效，分析影响治疗效果的相关因素。方法 对2008年10月~2010年4月巢湖市二院ICU 32例AECOPD合并Ⅱ型呼吸衰竭患者使用NPPV治疗，并对有效和无效组进行临床分析，比较两组在治疗前，治疗2、24 h的心率(HR)、呼吸频率(RR)、血气分析的变化。结果 有效组治疗后2 h PaO2、PaCO2明显改善，24 h后HR、RR、PaO2、PaCO2明显改善；无效组治疗2 h后与治疗前比PaO2、PaCO2无明显改善，治疗24 h各指标也无改善。结论 AECOPD合并Ⅱ型呼吸衰竭应用NPPV治疗2 h以及24 h后血气分析、心率、呼吸频率明显改善的患者预后较好。
[关键词] 慢性阻塞性肺疾病；呼吸衰竭；无创正压通气；治疗
[中图分类号] R563 [文献标识码] A [文章编号] 1674-4721(2012)03(a)-0045-02
Clinical analysis of noninvasive positive pressure ventilaion for chronic obstrutive pulmonary disease complicated with respiratory failure Ⅱ
CHU Chenglong
ICU of the Second People's Hospitial of Chaohu City in Anhui Province, Chaohu 238000, China
[Abstract] Objective To review and summarize the therapeutic effect of noninvasive positive pressure ventilation(NPPV) on treating acute exacerbation of chronic obstructive pulmonarg disease (AECOPD) complieated with resiratory failure, to analyse corrlative factors that offect therpeutic effeet. Methods During the October 2008 to April 2010, thirty two cases of patients with AECOPD complicated with respiratory failure were treated with NPPV, and the experience were summarized. The heart rate, respiratory rate and arterial blood gas analysis of two groups' patients were compared with before NPPV treatment, after 2 hours, and 24 hours of NPPV treatment. Results PaO2 and PaCO2 in success group 2 hours, and HR, R, PaO2, PaCO2, pH were improved rapidly after ventilating 24 hours, however, the indexes were notimp roved rapidly in failure group after ventilating 2 hours, there were not different improvement after ventilating 24 hours. Conclusion NPPV can be used for patients of AECOPD complicated with resporatory failure, prognosis is better if the patient is improved in blood gas analysis, respiratory rate, heart rate after ventilating 2 hours and 24 hours.
[Key words] Chronic obstruction pulmonary disease; Respiratory failure; Noninvasive positive pressure ventilation; Treatment
慢性阻塞性肺疾病(chronic obstructive pulmonarg disease ......
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