无创正压通气治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭临床分析  

Colposcopy in 24 cases of chronic obstructive pulmonary disease with respiratory failure Ⅱ blood gas analysis

作　　者：冯亦伟[1] 陈森钦[1] 刘汉冕[1] 王龙[1] 伍良[1] 

机构地区：[1]广东省高州市人民医院,广东高州525200

出　　处：《中国当代医药》2009年第11期38-39,共2页China Modern Medicine

摘　　要：目的:对24例COPD合并Ⅱ型呼吸衰竭患者无创正压通气治疗血气变化进行分析,总结慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的治疗效果及体会。方法:24例患者均使用无创正压通气,比较治疗前后血气分析参数变化。结果:本组24例患者均有低氧血症和高碳酸血症,经鼻导管吸氧(2L/min)后部分患者的SaO2达90%以上,用等量氧浓度通气治疗后,所有患者SaO2和PaCO2都有明显增加(P<0.05),通气1h,PaCO2虽有下降,但不显著(P>0.05);连续通气2h,PaCO2显著降低(P<0.05),患者持续通气12h以上,PaCO2持续下降,至出院以前PaCO2部分恢复正常,治疗中所有患者的心率降低,血压无明显变化。结论:使用无创正压通气治疗COPD合并呼吸衰竭(Ⅱ型),患者痛苦小,易接受,可以减少有创通气概率,减少住院时间及治疗费用。Objective： To analyze 24 cases of COPD combined with respiratory failure in patients with type Ⅱ noninvasive positive airway pressure changes in blood gas analysis, the sum of chronic obstructive pulmonary disease and respiratory failure Ⅱ type of treatment and experience. Methods： 24 patients were using non-invasive positive pressure ventilation, blood gas analysis before and after treatment compared with changes in the parameters. Results： 24 cases of patients with hypoxemia and have hypercapnia, nasal catheter oxygen （2 L/min） after some of the patients with SaO2 more than 90%, with an equivalent concentration of oxygen ventilation therapy, SaO2 and PaCO2 of all patients has been a marked increase（P〈0.05）, ventilation 1 h, PaCO2 decreazed, but was not significantly （P〉 0.05）; continuous ventilation 2 h, PaCO2 was significantly lower （P〈0.05）, in patients with more than 12 h continuous ventilation, PaCO2 continued to decline, to PaCO2 discharged from hospital before returning to normal part of treatment for all patients with lower heart rate, blood pressure remained unchanged. Conclusion： The use of noninvasive positive pressure ventilation treatment of COPD with respiratory failure（ 11 type）, the suffering of patients with small, easy to accept, can reduce the risk of invasive ventilation to reduce the length of stay and treatment costs.

关 键 词：慢性阻塞性肺疾病(COPD) Ⅱ型呼吸衰竭 IPAP EPAP BIPAP 

分 类 号：R563.5[医药卫生—呼吸系统]