高压力无创正压通气治疗慢性阻塞性肺疾病所致慢性高碳酸血症型呼吸衰竭的研究进展  

Research progress of high-intensity noninvasive positive pressure ventilation in the treatment of chronic hypercapnic respiratory failure caused by chronic obstructive pulmonary disease

作　　者：贾金涵 王晓龙[1] JIA Jinhan;WANG Xiaolong(First Aid Department,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆医科大学附属第二医院急救部,重庆400010

出　　处：《临床医学研究与实践》2022年第11期189-191,共3页Clinical Research and Practice

基　　金：重庆市科委社会事业与民生保障科技创新专项(No.cstc2017shmsA130050)。

摘　　要：进行性发展至终末期的慢性阻塞性肺疾病(COPD)患者常伴有慢性高碳酸血症型呼吸衰竭(CHRF),并易受环境、气候、感染等因素影响,致使COPD急性加重,出现肺性脑病等严重并发症,且长期高碳酸血症状态为COPD患者远期不良预后的独立危险因素。近年来,有研究发现高压力无创正压通气(Hi-NPPV)较低压力无创正压通气(Li-NPPV)能更好地降低CHRF患者的血碳酸水平,改善其远期预后及生活质量,但对心排出量及腹内压有一定的负面影响。同时,有少量研究显示Hi-NPPV还可降低急性高碳酸血症患者的气管插管率。本文就Hi-NPPV治疗COPD所致CHRF的研究进展作一综述。Chronic obstructive pulmonary disease(COPD)patients who develop to the end stage are often accompanied by chronic hypercapnic respiratory failure(CHRF),and are vulnerable to environment,climate,infection and other factors,resulting in acute exacerbation of COPD and serious complications such as pulmonary encephalopathy.Long term hypercapnia is an independent risk factor for long-term poor prognosis of COPD patients.In recent years,some studies have found that high-intensity noninvasive positive pressure ventilation(Hi-NPPV)can better reduce the blood carbonate level and improve the long-term prognosis and quality of life of CHRF patients than low-intensity noninvasive positive pressure ventilation(Li-NPPV),but it has a certain negative impact on cardiac output and intra-abdominal pressure.At the same time,a few studies have shown that Hi-NPPV can also reduce the intubation rate of patients with acute hypercapnia.This paper reviews the research progress of Hi-NPPV in the treatment of CHRF caused by COPD.

关 键 词：慢性阻塞性肺疾病 慢性高碳酸血症型呼吸衰竭 高压力无创正压通气 低压力无创正压通气 

分 类 号：R563.9[医药卫生—呼吸系统]