慢性阻塞性肺病高碳酸血症患者增强自主呼吸后的动脉血气变化  

Effect of accelerating spontaneous breathing on arterial blood gases in patients with hypercapnia due to chronic obstructive pulmonary disease

作　　者：蔡映云[1] 徐凤平[1] 钮善福[1] 

机构地区：[1]上海医科大学附属中山医院肺病学教研室

出　　处：《中国危重病急救医学》1996年第4期219-220,共2页Chinese Critical Care Medicine

摘　　要：为了观察自主呼吸增强后通气和气体代谢变化对动脉血气的影响，对７例健康志愿者和５例慢性阻塞性肺病（ＣＯＰＤ）患者进行体外膈肌起搏，对９例ＣＯＰＤ患者静脉滴注可拉明，另外９例口服阿米脱林。结果显示：综合通气和代谢两方面变化的指标△ＶＡ％／△ＶＣＯ２％能预示ＰａＣＯ２变化趋势；全部受检者中△ＶＡ％／△ＶＣＯ２％＞１者２２例，除１例外ＰａＣＯ２均降低；而△ＶＡ％／△ＶＣＯ２％＜１的７例中ＰａＣＯ２增高５例，降低２例；健康志愿者△ＶＣＯ２／△ＶＡ均＜３０ｍｌ／Ｌ，而ＣＯＰＤ患者则大都＞３０ｍｌ／Ｌ。说明ＣＯＰＤ患者增强自主呼吸时机体代谢增强削弱了肺泡通气增加的效果；口服阿米脱林组ＰａＯ２增高较ＰａＣＯ２降低明显，提示阿米脱林除增强通气以外，还能改善换气功能。7 healthy volunteers and 5 patients with chronic obstructive pulmonary disease (COPD) were paced by external diaphragmatic pacer.9 COPD patients were given coramin by intravenous drip for 4 hours.Another 9 COPD patients took 150mg of almitrine bismesylate orally.The accelerating spontaneous breathing induced increment of alveolar ventilation ( A) and CO 2 production (CO 2).Δ A%/ΔCO 2% could predict the change of PaCO 2.Among 22 patients with Δ A%/ΔCO 2%>1,PaCO 2 decreased in 21 Five out of seven patents with Δ A%Δ/CO 2%<1 had increased PaCO 2

关 键 词：阻塞性肺疾病 自主呼吸 动脉血气 高碳酸血症 

分 类 号：R563[医药卫生—呼吸系统]