摘要
目的探讨无创通气治疗由慢性阻塞性肺部疾病(chronic obstructivepulmonary disease,COPD)引起Ⅱ型呼吸衰竭而出现昏迷的患者的临床疗效。方法对47例呼吸道分泌物不多的COPDⅡ型呼吸衰竭引起昏迷的患者进行无创双水平正压(BIPAP)通气,观察上机前和上机后2小时及上机后10小时的神志、心率、呼吸频率、血气分析,成功脱机率,有创通气上机率。结果47例中38例(81%)进行无创通气后2、10h,神志、心率、呼吸频率、血气分析均有显著性改善,并成功避免了有创通气,这其中包括3例肥胖患者(BMI≥30)。9例(19%)加重患者。结论呼吸道分泌物不多的COPDⅡ型呼吸衰竭昏迷患者无创通气仍不失为一种有效的治疗手段。对伴有肥胖的患者选择无创通气应慎重。
Objective To investigate noninvasive ventilation on exanimation due to chronic obstructive pulmonary disease （COPD） with Ⅱ type respiratory failure. Methods 47 cases of exanimation due to COPD with Type Ⅱ respiratory failure received nonin-vasive ventilation in addition to conventional medications. Arterial blood gases were measured and the changes of clinical symptoms were observed before and after ventilation at 2 hours and 10 hours respectively. Results After 10 hours of noninvasive ventilation 81% （38/ 47 ） cases with exanimation turn into consciousness, and arterial blood gases improved significantly. The symptoms and arterial blood gases of 7 in 10 obese patients with noninvasive ventilation did not show obvious improvement. Conclusion Noninvasive ventilation is an effective method for the treatment of exanimation due to COPD with Type Ⅱ respiratory failure. This may not however apply to obese patients.
出处
《临床肺科杂志》
2008年第2期170-171,共2页
Journal of Clinical Pulmonary Medicine
关键词
无创通气
COPD
Ⅱ型呼吸衰竭
昏迷
noninvasive ventilation
respiratory failure
chronic pulmonary disease
exanimation
