无创正压通气对AECOPD合并高乳酸血症患者的疗效分析  

Clinic analysis of non-invasive positive pressure ventilation in the treatment of COPD patients at acute exacerbation stage complicated with hyperlactacidemia

作　　者：刘春丽 程正跃 郑运江[2] 

机构地区：[1]上海市闸北区市北医院急诊科,上海200000 [2]上海交通大学附属新华医院崇明分院急诊科,上海200092

出　　处：《临床肺科杂志》2013年第3期502-504,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的观察无创正压通气(NIPPV)对AECOPD合并高乳酸血症的治疗效果。方法选择符合AECOPD诊断标准并且血乳酸>2mmol/L的患者44例,随机分成NIPPV组23例及常规治疗组21例。结果治疗3 d后,两组患者的血气分析结果、呼吸频率、血乳酸、心率、脉搏氧饱和度等指标均较治疗前显著改善(P<0.05 or P<0.01),但NIPPV组的血乳酸水平、PaO2及PaCO2的改善效果明显(P<0.05)。结论 AECOPD患者早期使用NIPPV能迅速降低患者的CO2蓄积、改善缺氧、降低血乳酸水平,提高救治成功率。Objective To observe the effect of non-invasive positive pressure ventilation （NIPPV） in the treatment of COPD pa- tients at acute exacerbation stage complicated with hyperlactacidemia. Methods 44 patients, who had been diagnosed as AECOPD and the level of blood lactic acid was higher than 2 retool/L, were randomly divided into the NIPPV group （n = 24） and the control group （n = 21 ）. Results 3 days after the treatment, the result of blood gas analysis, level of lactic acid, breathing rate, oxygen saturation and heart rate were significantly improved in the NIPPV group （P 〈 0. 05 or P 〈 0. 01 ）. However, the improvement of the levels of lactic acid, POe and PCO2 were more pronounced in the NIPPV group than in the control group （P 〈0. 05）. Conclusion The early use of NIPPV can reduce CO2 accumulation, lower blood lactate levels, and improve tissue oxygenation and treatment success rate in the treatment of COPD patients at acute exacerbation stage complicated with hyperlactacidemia.

关 键 词：慢性阻塞性肺病 急性加重 无创正压通气 血乳酸 治疗 

分 类 号：R563.9[医药卫生—呼吸系统]