中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2012年
9期
927-930
,共4页
慢性阻塞性肺疾病%有创机械通气%无创机械通气
慢性阻塞性肺疾病%有創機械通氣%無創機械通氣
만성조새성폐질병%유창궤계통기%무창궤계통기
Chronic obstructive pulmonary disease%Invasive positive pressure ventilation%Noninvasive positive pressure ventilation
目的 比较慢性阻塞性肺疾病急性加重合并呼吸衰竭患者应用无创与有创机械通气的效果.方法 慢性阻塞性肺疾病急性加重合并呼吸衰竭患者分为有创(35例)和无创机械通气组(37例),回顾性分析两组患者治疗前后的临床资料.结果 有创组机械通气2h后pH、动脉血氧分压(PaO2)、动脉血二氧化碳分压( PaCO2)、格拉斯哥昏迷评分(GCS)评分、心率、呼吸频率较治疗前均明显改善[分别为(7.35±0.05)、(7.23±0.02),(92.4±14.5)、(51.3±9.4) mm Hg,(56.0±7.7)、(82.6±8.1)mm Hg,(10.5±1.1)、(8.5±1.2)分、(110±12)、(131±19)次/min,( 26±4)、(35±8)次/min,P ＜0.05或P＜0.01]；而无创机械通气组仅PaO2、心率、呼吸频率较治疗前明显改善[分别为(78.6±8.8)、(53.1±8.9)mm Hg,(110±24)、(128±23)次/min,(26±5)、(36±9)次/min,P均＜0.05],6h后pH、PaCO2、GCS才明显改善[分别为7.35±0.03、7.25 ±0.01,(59.0±6.3)、(79.8±7.0) mm Hg,(10.6±2.0)、(8.5±2.5)分,P＜0.05或P＜0.01].有创与无创机械通气组患者的ICU住院时间[分别为(15±4)、(14 ±4)d,t=1.102]、机械通气时间[分别为(168±25)、(170±23)d,t=1.214]、ICU病死率[分别为(22.8％ (8/28)、21.6％(8/37),x2=0.016]的比较差异无统计学意义(P均＞0.05).结论 有创机械通气组可以更快地改善病情,无创机械通气组部分患者需要气管插管,但两组在ICU住院时间、机械通气时间、ICU病死率无明显差别.
目的 比較慢性阻塞性肺疾病急性加重閤併呼吸衰竭患者應用無創與有創機械通氣的效果.方法 慢性阻塞性肺疾病急性加重閤併呼吸衰竭患者分為有創(35例)和無創機械通氣組(37例),迴顧性分析兩組患者治療前後的臨床資料.結果 有創組機械通氣2h後pH、動脈血氧分壓(PaO2)、動脈血二氧化碳分壓( PaCO2)、格拉斯哥昏迷評分(GCS)評分、心率、呼吸頻率較治療前均明顯改善[分彆為(7.35±0.05)、(7.23±0.02),(92.4±14.5)、(51.3±9.4) mm Hg,(56.0±7.7)、(82.6±8.1)mm Hg,(10.5±1.1)、(8.5±1.2)分、(110±12)、(131±19)次/min,( 26±4)、(35±8)次/min,P ＜0.05或P＜0.01]；而無創機械通氣組僅PaO2、心率、呼吸頻率較治療前明顯改善[分彆為(78.6±8.8)、(53.1±8.9)mm Hg,(110±24)、(128±23)次/min,(26±5)、(36±9)次/min,P均＜0.05],6h後pH、PaCO2、GCS纔明顯改善[分彆為7.35±0.03、7.25 ±0.01,(59.0±6.3)、(79.8±7.0) mm Hg,(10.6±2.0)、(8.5±2.5)分,P＜0.05或P＜0.01].有創與無創機械通氣組患者的ICU住院時間[分彆為(15±4)、(14 ±4)d,t=1.102]、機械通氣時間[分彆為(168±25)、(170±23)d,t=1.214]、ICU病死率[分彆為(22.8％ (8/28)、21.6％(8/37),x2=0.016]的比較差異無統計學意義(P均＞0.05).結論 有創機械通氣組可以更快地改善病情,無創機械通氣組部分患者需要氣管插管,但兩組在ICU住院時間、機械通氣時間、ICU病死率無明顯差彆.
목적 비교만성조새성폐질병급성가중합병호흡쇠갈환자응용무창여유창궤계통기적효과.방법 만성조새성폐질병급성가중합병호흡쇠갈환자분위유창(35례)화무창궤계통기조(37례),회고성분석량조환자치료전후적림상자료.결과 유창조궤계통기2h후pH、동맥혈양분압(PaO2)、동맥혈이양화탄분압( PaCO2)、격랍사가혼미평분(GCS)평분、심솔、호흡빈솔교치료전균명현개선[분별위(7.35±0.05)、(7.23±0.02),(92.4±14.5)、(51.3±9.4) mm Hg,(56.0±7.7)、(82.6±8.1)mm Hg,(10.5±1.1)、(8.5±1.2)분、(110±12)、(131±19)차/min,( 26±4)、(35±8)차/min,P ＜0.05혹P＜0.01]；이무창궤계통기조부PaO2、심솔、호흡빈솔교치료전명현개선[분별위(78.6±8.8)、(53.1±8.9)mm Hg,(110±24)、(128±23)차/min,(26±5)、(36±9)차/min,P균＜0.05],6h후pH、PaCO2、GCS재명현개선[분별위7.35±0.03、7.25 ±0.01,(59.0±6.3)、(79.8±7.0) mm Hg,(10.6±2.0)、(8.5±2.5)분,P＜0.05혹P＜0.01].유창여무창궤계통기조환자적ICU주원시간[분별위(15±4)、(14 ±4)d,t=1.102]、궤계통기시간[분별위(168±25)、(170±23)d,t=1.214]、ICU병사솔[분별위(22.8％ (8/28)、21.6％(8/37),x2=0.016]적비교차이무통계학의의(P균＞0.05).결론 유창궤계통기조가이경쾌지개선병정,무창궤계통기조부분환자수요기관삽관,단량조재ICU주원시간、궤계통기시간、ICU병사솔무명현차별.
Objective To compare the different efficacy between invasive positive pressure ventilation and noninvasive positive pressure ventilation of acute exacerbation chronic obstructive pulmonary disease.Methods Patients with acute exacerbation chronic obstructive pulmonary disease were randomly divided into invasive positive pressure mechanical ventilation ( IPPV ) group ( n =35 ) and noninvasive positive pressure mechanical ventilation (NPPV)group (n =37 ),and clinical data before and after treatment were analyzed retrospectively.Results After 2 hours of invasive positive pressure mechanical ventilation,pH,arterial oxygen partial pressure( PaO2 ),arterial carbon dioxide partial pressure ( PaCO2 ),heart rate ( HR ),respiratory rate(RR),Glasgow coma scale(GCS) score were better than those before treatment[ pH:(7.35 ± 0.05)vs ( 7.23 ± 0.02 ) ; PaO2:( 92.4 ± 14.5 ) mm Hg vs ( 51.3 ± 9.4 ) mm Hg; PaCO2:( 56.0 ± 7.7 ) mm Hg vs( 82.6 ±8.1)mm Hg;GCS:(10.5 ± 1.1)points vs(8.5 ± 1.2)points;HR:(110 ± 12) times/min vs(131 ± 19) times/min ; RR:( 26 ± 4) times/min vs ( 35 ± 8 ) times/min ; P ＜ 0.05 or P ＜ 0.01 ].But in NPPV group,only the PaO2,HR,RR were better than those before treatment [ PaO2:( 78.6 ± 8.8 )mm Hg vs ( 53.1 ± 8.9 ) mm Hg; HR:( 110 ± 24) times/min vs ( 128 ± 23 ) times/min ; RR:( 26 ± 5 ) times/min vs ( 36 ± 9 ) times/min; P ＜ 0.05 ].And after 6 hours,pH,PaCO2,GCS score were significantly better in NPPV group [ pH:( 7.35 ± 0.03 ) vs ( 7.25 ±0.01 ) ;PaCO2:(59.0 ±6.3) mm Hg vs(79.8 ±7.0) mm Hg;GCS:( 10.6 ± 2.0) points vs( 8.5 ±2.5) points;P ＜ 0.05 or P ＜ 0.01 ].There was no difference on the days in ICU [ ( 15 ± 4) d vs ( 14 ± 4 ) d,t =1.102,P ＞0.05 ],the duration of mechanical ventilation[ ( 168 ± 25 )d vs( 170 ± 23 )d,t =1.214,P ＞ 0.05 ],the mortality in ICU (22.8％ (8/28) vs 21.6％ (8/37),x2 =0.016,P ＞ 0.05) between IPPV group and NPPV group.Conclusion IPPV can improve the situation of AECOPD quickly,but in NPPV group some patients need intubation.However,there was no significant difference on the days in ICU,the duration of mechanical ventilation,the mortality in ICU between IPPV and NPPV.
