CAJ | 학술논문

目的观察无创正压通气(NIPPV)治疗慢性阻塞性肺病(COPD)合并Ⅱ型呼吸衰竭的疗效及其与体重指数(BMI)的关系.方法将126例COPD并发Ⅱ型呼吸衰竭患者按体重指数分为正常体重指数组(BMIN组),低体重指数组(BMIL组)和高体重指数组(BMIH组),三组患者除常规治疗外加用NIPPV辅助通气治疗.治疗前和治疗后每天测定三组患者的呼出气潮气量(EVT)、呼吸频率(RR)、动脉血气指标(pH值、PaO2、PaCO2),观察其变化,直至PaCO2指标正常,此后每3天检测上述各项指标.结果 NIPPV辅助通气治疗后BMIN组患者疗效明显好于BMIL组和BMIH组,组间比较差异均有统计学意义(P＜0.05),但三组患者EVT比较差异无统计学意义(P>0.05).结论 NIPPV辅助通气治疗COPD并Ⅱ型呼吸衰竭时,体重指数对其治疗和预后均有影响,BMIN组治疗效果及其预后较其它两组好.EVT不能用于指导NIPPV的调节.
목적 관찰무창정압통기(NIPPV)치료만성조새성폐병(COPD)합병Ⅱ형호흡쇠갈적료효급기여체중지수(BMI)적관계.방법 장126례COPD병발Ⅱ형호흡쇠갈환자안체중지수분위정상체중지수조(BMIN조),저체중지수조(BMIL조)화고체중지수조(BMIH조),삼조환자제상규치료외가용NIPPV보조통기치료.치료전화치료후매천측정삼조환자적호출기조기량(EVT)、호흡빈솔(RR)、동맥혈기지표(pH치、PaO2、PaCO2),관찰기변화,직지PaCO2지표정상,차후매3천검측상술각항지표.결과 NIPPV보조통기치료후BMIN조환자료효명현호우BMIL조화BMIH조,조간비교차이균유통계학의의(P＜0.05),단삼조환자EVT비교차이무통계학의의(P>0.05).결론 NIPPV보조통기치료COPD병Ⅱ형호흡쇠갈시,체중지수대기치료화예후균유영향,BMIN조치료효과급기예후교기타량조호.EVT불능용우지도NIPPV적조절.
Objective To investigate the effect of Body Mass Index (BMI) on the treatment of chronic obstructive pulmonary disease(COPD)with type Ⅱ respiratory failure by non-invasive positive pressure ventilation(NIPPV).Methods The totals of 126 patients of COPD disease with type Ⅱ respiratiory failure were divided into three groups according to different BMI.The routine therapy and NIPPV were given.The measures of respiratory rate (RR),exhaled tidal volume (EVT) and arterial gas analysis were observed daily before and after the treatment until PaCO2 turned normal,and were subsequently tested every three days.Results The efficacy of NIPPV on the patients with normal BMI (BMIN) is significantly better than the ones with low BMI (BMIL) and high BMI (BMIH)(P＜0.05).The difference of EVT among three groups was not significant(P>0.05).Conclusion BMI has an impact on the treatment and prognosis of COPD with type Ⅱ respiratory failure by NIPPV,the efficacy of NIPPV on the treatment of patients with BMIN is significant better than the ones with BMIL and BMIH.In addition,The regulation of NIPPV cannot be guided by EVT.