摘要
目的:探讨高碳酸性呼吸衰竭患者(慢性阻塞性肺病,肥胖低通气综合征和支气管扩张)使用无创性机械通气的治疗价值。方法:116例慢性阻塞性肺病,19例肥胖低通气综合征和46例支气管扩张患者,因慢性高碳酸性呼吸衰竭而住院。第1次住院时未使用无创性机械通气,而在第2次住院时予以无创性机械通气。观察患者的肺功能,动脉血气和住院天数的变化。结果:慢性阻塞性肺病、肥胖低通气综合征和支气管扩张患者在使用无创性机械通气的过程中:①大多患者能表现很好的依从性,占91％。②动脉血气有所改善。PaCO2在慢性阻塞性肺病患者由62±10mmHg降至53±6 mmHg,(P<0．01);在肥胖低通气综合征患者由52±10mmHg降至42±7 mmHg,(P<0．001);在支气管扩张患者由56 ±6mmHg降至44±10mmHg,(P<0．005)。同时PaO2也有上升,分别由:(61±13)mmHg、(60±12)mmHg、(58 ±11)mmHg升到(71±15)mmHg、(71±11)mmHg和(75±18)mmHg,(P均<0．001)。③与未用无创性机械通气的住院时间相比,住院天数有减少(P<0．05)。结论:无创机械通气在慢性阻塞性肺病、肥胖低通气综合征和支气管扩张的治疗中依从性好、动脉血气有改善和住院天数缩短。
Objective： To study the effect of noninvasive positive-pressure ventilation （NIPPV） in treatment of chronic hypereapnie respiratory failure caused by chronic obstructive pulmonary disease,obesity-hypoventilation syndrome and bronchiectasis. Methods ： From 2002 to 2005 , there were 116 patients with obstructive pulmonary disorders , 19 patients with obesity-hypoventilation syndrome and 46 patients with bronchiectasis were treated in shanghai No. 6 Hopital because of hupercapic respiratory failure, their clinical data were analyzed respectively. All patients were not treated by NIPPV firstly in terms of chronic hypereapnic respiratory failure; But at the second time these inpatients were treated by NIPPV. Given pulmonary function , arterial blood gas and calculated the hospitalization dates. Results： （1）Patients had the high probability of pursuing NIPPV, the compliance rate was high （compliance rate, 91%）. （2）Tbe date of arterial blood gas levels were improved. The arterial PaCO2 decrease from 62 ± 10 mmHg to 53 ± 6 mmHg in chronic obstructive pulmonary disease（ P〈0. 01 ） ; PaCO2 from 52 ± 10 mm Hg to 42±7 mmHg in obesity-hypoventilation syndrome（ P〈0. 001）; PaCO2 from 56 ± 6 mmHg to 44 ± 10 mmHg in bronehiectasis（P〈0.005）. Meanwhile the arterial PaO2 increase from 61 ± 13 mmHg,60 ± 12 mmHg,58 ± 11 mmHg to 71 ± 15 mmHg,71 ± 11 mmHg,75 ± 18 mmHg in the three groups respectively（ all P〈0. 001）. （3）Hospitalization dates decreased in all groups after initiating NIPPV, when compared with the year before NIPPV （P〈0. 05）. Conclusion： Noninvasive ventilation has partly effect on chronic obstructive pulmonary disease, obesity-hypoventilation syndrome and bronehiectasis .
出处
《中国临床医学》
北大核心
2006年第2期201-203,共3页
Chinese Journal of Clinical Medicine
关键词
无创性机械通气
慢性阻塞性肺病
肥胖低通气综合征
支气管扩张
Noninvasive positive-pressure ventilation
Chronic obstructive pulmonary disease
Obesity-hypoventilation syndrome
Bronchiectasis
