中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2010年
2期
166-167
,共2页
肺疾病,慢性阻塞性%通气机,机械%呼吸功能不全
肺疾病,慢性阻塞性%通氣機,機械%呼吸功能不全
폐질병,만성조새성%통기궤,궤계%호흡공능불전
Pulmonary disease,chronic obstructive%Ventilators,mechanicai%Respiratory insufficiency
目的 观察早期应用无创机械通气治疗慢性阻塞性肺疾病(COPD)并发呼吸衰竭的疗效.方法 58例COPD并发呼吸衰竭患者,根据开始使用无创机械通气治疗时间的不同,分为早期应用组(Ⅰ组27例)及非早期应用组(Ⅱ组31例),比较两组患者病情好转时间、机械通气时间、有效率、气管插管率和病死率等.结果 58例患者中有54例经无创机械通气治疗后,临床症状明显改善,呼吸频率及心率明显减慢,氧饱和度和动脉血氧分压明显增加,二氧化碳分压恢复到正常水平,动脉血pH恢复正常,与治疗前比较差异有统计学意义(P＜0.05).Ⅰ组病情好转时间(2.3±1.1)h、机械通气时间(5.9±2.7)h,与Ⅱ组的(5.7±3.2)h、(9.8±4.3)h比较,差异均有统计学意义(t=7.38、5.64,均P＜0.01);Ⅰ组全部治愈(100%),无气管插管及死亡病例,Ⅱ组27例治愈(87%),气管插管4例,其中死亡2例(6%),两组比较差异均有统计学意义(P＜0.05或P＜0.01).结论 采用无创机械通气治疗COPD并发呼吸衰竭疗效确切,早期应用可提高治愈率.
目的 觀察早期應用無創機械通氣治療慢性阻塞性肺疾病(COPD)併髮呼吸衰竭的療效.方法 58例COPD併髮呼吸衰竭患者,根據開始使用無創機械通氣治療時間的不同,分為早期應用組(Ⅰ組27例)及非早期應用組(Ⅱ組31例),比較兩組患者病情好轉時間、機械通氣時間、有效率、氣管插管率和病死率等.結果 58例患者中有54例經無創機械通氣治療後,臨床癥狀明顯改善,呼吸頻率及心率明顯減慢,氧飽和度和動脈血氧分壓明顯增加,二氧化碳分壓恢複到正常水平,動脈血pH恢複正常,與治療前比較差異有統計學意義(P＜0.05).Ⅰ組病情好轉時間(2.3±1.1)h、機械通氣時間(5.9±2.7)h,與Ⅱ組的(5.7±3.2)h、(9.8±4.3)h比較,差異均有統計學意義(t=7.38、5.64,均P＜0.01);Ⅰ組全部治愈(100%),無氣管插管及死亡病例,Ⅱ組27例治愈(87%),氣管插管4例,其中死亡2例(6%),兩組比較差異均有統計學意義(P＜0.05或P＜0.01).結論 採用無創機械通氣治療COPD併髮呼吸衰竭療效確切,早期應用可提高治愈率.
목적 관찰조기응용무창궤계통기치료만성조새성폐질병(COPD)병발호흡쇠갈적료효.방법 58례COPD병발호흡쇠갈환자,근거개시사용무창궤계통기치료시간적불동,분위조기응용조(Ⅰ조27례)급비조기응용조(Ⅱ조31례),비교량조환자병정호전시간、궤계통기시간、유효솔、기관삽관솔화병사솔등.결과 58례환자중유54례경무창궤계통기치료후,림상증상명현개선,호흡빈솔급심솔명현감만,양포화도화동맥혈양분압명현증가,이양화탄분압회복도정상수평,동맥혈pH회복정상,여치료전비교차이유통계학의의(P＜0.05).Ⅰ조병정호전시간(2.3±1.1)h、궤계통기시간(5.9±2.7)h,여Ⅱ조적(5.7±3.2)h、(9.8±4.3)h비교,차이균유통계학의의(t=7.38、5.64,균P＜0.01);Ⅰ조전부치유(100%),무기관삽관급사망병례,Ⅱ조27례치유(87%),기관삽관4례,기중사망2례(6%),량조비교차이균유통계학의의(P＜0.05혹P＜0.01).결론 채용무창궤계통기치료COPD병발호흡쇠갈료효학절,조기응용가제고치유솔.
Objective To evaluate the clinical value of early use of non-invasive ventilation in chronic obstructive pulmonary disease(COPD)patients with respiratory failure.Methods Totally 58 patients with COPD induced respiratory failure,admitted from January 2007 to June 2009,received BIPAP non-invasive ventilation treatment,and were retrospectively studied.The changes of respiration rate,heart rate,arterial blood gas before and after non-invasive ventilation application were compared.According to the application time of non-invasive ventilation,58 patients were divided into two groups:group Ⅰ(early application group,n=27)and group Ⅱ(non-early application group,n=31).The time to improve the symptoms,the application time of non-invasive ventilation,cure rate,tracheal intubation rate and mortality were compared between the two groups.Results Non-invasive ventilation was applied on 54 patierts effectively.Their respiratory rate,heart rate significantly decreased,PH,PaO_2 and SaO_2 significantly increased and PaCO_2 significantly decreased(P＜0.05).The tracheal intubation was performed in 4 patients.The time needed to improve the symptoms and the application time of non-invasive ventilation were significantly different between group Ⅰ and group Ⅱ(t=7.38,5.64,all P＜0.01).In group Ⅰ,all patients were cured,no tracheal intubation.In group Ⅱ,27 patients were cured,4 patients required tracheal intubation,and 2 died.Conclusion Non-invasive ventilation application is effective in the treatment of COPD patients with respiratory failure.Early application can increase the cure rate and reduce mortality.
