无创呼吸机辅助通气联合胸腔闭式引流治疗COPD呼衰合并胸腔积液病人的临床研究  

Research on Combined Use of Non-invasive Ventilator and the Closed Drainage of Thoracic Cavity for the Treatment of Patients with COPD Combined with Respiratory Failure as Well as Hydrothorax

作　　者：茅敏华[1] 姜觉如[1] 蔡红[1] 

机构地区：[1]启东市人民医院,江苏启东226200

出　　处：《临床肺科杂志》2011年第4期513-515,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的研究无创正压通气联合胸腔闭式引流治疗慢性阻塞性肺病(COPD)呼衰合并胸腔积液的临床应用价值。方法对56例COPD呼衰合并胸腔积液患者在应用无创正压通气及药物治疗疗效不显后使用中心静脉导管行胸腔闭式引流,监测胸腔积液引流前后主要血气参数、呼吸频率和潮气量的变化。结果 COPD呼衰合并胸腔积液患者在应用无创正压通气及药物治疗疗效不显时联合胸腔闭式引流术后呼吸频率下降,潮气量增加,PaO2显著上升、PaCO2显著下降。引流前后比较有显著差异(P<0.05)。结论无创正压通气联合胸腔闭式引流治疗COPD呼衰合并胸腔积液疗效显著,无明显并发症,值得临床推广使用。Objective To evaluate the clinical use of noninvasive positive pressure ventilation combined with closed drainage of thoracic cavity for the treatment of patients with COPD combined with respiratory failure as well as hydrothorax.Method56 patients with COPD combined with respiratory failure as well as hydrothorax have been adopted noninvasive positive pressure ventilation followed by drug therapy.Howerver,less curative effect is achieved.Afterwards,the closed thoracic drainage with central venous catheter is done.Meanwile the primary changes in blood gas parameters before and after the drainage,breathing rate and Tidal volume are monitored.ResultWhile noninvasive positive pressure ventilation and drug therapy show less curative effect,the closed thoracic drainage with central venous catheter can be done.As the results indicate there is a striking difference before and after the drainage（P0.05）;there is a decrease in breathing rate,an increase in Tidal volume,and pronounced elevation of PaO2 and depression of PaCO2 seen in the patients with COPD combined with respiratory failure as well as hydrothorax.ConclusionNoninvasive positive pressure ventilation combined with the closed drainage of thoracic cavity is proved to have prominent effect in the treatment of COPD combined with respiratory failure as well as hydrothorax.It is proved to have no obvious complications and worth to be widely used clinically.

关 键 词：无创呼吸机 胸腔闭式引流 慢性阻塞性肺病 呼衰 胸腔积液 

分 类 号：R563.9[医药卫生—呼吸系统]