175例高碳酸血症治疗与转归分析  

Treatments of Hypercapnia in COPD Patients and Their Outcome

作　　者：缪礼丽[1] 刘昌起[1] 

机构地区：[1]天津市胸科医院,300051

出　　处：《天津医药》1999年第2期72-74,共3页Tianjin Medical Journal

摘　　要：目的：对１７５例高碳酸血症患者的临床转归进行分析。观察项目：（１）可拉明治疗高碳酸血症的疗效。（２）高碳酸血症与神志障碍的关系。（３）分析对高碳酸血症机械通气治疗的影响因素。（４）对高碳酸血症患者预后因素进行分析。结果：（１）９２例高碳酸血症经可拉明治疗后ｐＨ、ＰａＣＯ_２、ＰａＯ_２及 ＳａＯ_２均改善（Ｐ＜０．０１），且冲击法优于持续用药法（Ｐ＜０．０５）。（２）神志障碍与ｐＨ、ＰａＯ_２有关（Ｐ＜０．０５）。（３）病死率以年龄＞６０岁、病程＞２０年、并发 ３个以上脏器衰竭及 ＰＨ＜７．２０者为高。（４）经机械通气治疗的 ２６例高碳酸血症患者，肺间质纤维化死亡率最高，并发多脏器衰竭、呼衰持续时间＞３天及治疗后ＰａＯ_２＜６．６７ ｋＰａ者病死率也高。TO analyse the clinical outcome of 175 cases of COPD with hypercapnia following their treatment. Method: 1 To observe thd curative effect of treatments with nikethamide for hypercapnia;2 To analyse the relationship between hypercapnia and coaseious abnormalities;3 To analyse the influence factors of mechanical ventilatory treatments;4 To analyse the prognosis factors of hypercapnia. Conclusion: 1 The clinical usage of nikethamide on intravenous drip had practical value for district or country hospitals and for some patients who refuse mechanical ventilatory treatments,While the nikethamide on bolus intravehasly had more response than continual drip(p<0 .01 );2 Conscious abnomalities of hypercapnia was related to hypoxemia and acidemia(p< 0.01 );3 The prognosis of hypercapnia was related to age, course of disease, MOF and pH (P< 0.01 );4 The curative effect of mechanical ventilatory treatments in hypercapnia was related to underlying diseases, duration of respiratory failure, MOF and improvment of PaO_2 after oxygen therapy(P<0.05).

关 键 词：高碳酸血症 药物疗法 可拉明 机械通气 预后 

分 类 号：R589.605[医药卫生—内分泌]