慢性阻塞性肺疾病合并昏迷并非无创正压通气的禁忌症  

Non-invasive positive pressure ventilation is not a contraindication of chronic obstructive pulmonary disease combined coma

作　　者：金涛[1] 田卓民[1] 沈莉[1] 苏毅[1] 辛绍斌[1] 

机构地区：[1]天津市人民医院ICU科,300121

出　　处：《临床肺科杂志》2007年第5期444-446,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的评价无创正压通气(NIPPV)治疗慢性阻塞性肺疾病(COPD)急性加重期合并昏迷的价值。方法48例COPD急性加重期患者,按照格拉斯哥昏迷评分(GCS)分为两组,GCS≤8为昏迷组,GCS>8为对照组。比较两组间NIPPV治疗后的转归和治疗前后动脉血PH值、氧合指数(PaO2/FiO2)、PaCO2。结果昏迷组与对照组的NiPPV有显著差异(P<0.01),两组间的APACHEⅡ分值无显著差异,两组治疗前与治疗后2、24h的动脉血PH值、PaO2/FiO2、PaCO2均有显著差异(P<0.05);治疗成功组与失败组的APACHEⅡ分值有显著差异(P<0.05),两组间的GCS无显著差异。结论NIPPV对COPD急性加重期合并昏迷患者疗效确切,值得临床推广。Objective To evaluate the importance of non-invasive positive pressure ventilation （NIPPV） in treating exacerbations of chronic obstructive pulmonary disease （COPD） combined coma. Methods 48 patients with exacerbations of COPD were divided into two groups： coma group （ 17 cases, GCS ≤8 ） and control group （31 cases, GCS 〉 8 ）. The study compared the prognosis between the two groups in the measures of artery blood PH, oxygenation index （ PaO2/FiO2 ）, PaCO2 before and after NIPPV. Results There was significant difference in IPAP between the two groups （ P 〈0. 01 ） and no significant difference in APACHE Ⅱ score was found between the two groups. There were significant differences in artery blood PH, oxygenation index （PaO2/FiO2 ）, PaCO2 before and after NIPPV （P 〈 0. 05）. There were slgnificant differences in APACHE Ⅱscores in the successful group and the failure group （P 〈0. 05）. There was no significant difference in GCS between the two groups. Conclusion NIPPV is effective in treating exacerbations of COPD combined coma, which is worth being recommended for a wider use in clinical practice.

关 键 词：无创正压通气 慢性阻塞性肺疾病 氧合指数 

分 类 号：R563.9[医药卫生—呼吸系统]