摘要
目的探讨COPD并严重Ⅱ型呼吸衰竭的预后因素及防治对策。方法97例未行机械通气治疗的COPD并严重Ⅱ型呼吸衰竭患者,据治疗结果分为好转组和死亡组,比较两组的临床及血气特点。结果好转58例(59.8%),死亡39例(40.2%)。死亡组较好转组年龄大,死亡组营养不良、意识障碍、酸中毒和高碳酸血症均较好转组严重,二者比较有显著差异性。结论年龄、营养不良、意识障碍、酸中毒和高碳酸血症是影响COPD并严重Ⅱ型呼吸衰竭患者预后的重要因素。对于pH>7.20,PaCO2<90mmHg,意识障碍较轻,无营养不良患者药物治疗有较好效果,但应及时评估疗效,经药物治疗短时间内效果不佳者,应果断予机械通气治疗。对于pH<7.20,PaCO2>90mmHg,意识障碍较重,营养不良患者药物治疗效果差,应早期予机械通气治疗。
Objective To explore the related factors of prognosis and treatment in the patients with severe type-Ⅱ respiratory failure of chronic obstructive pulmonary diseases. Methods 97 patients with severe type- Ⅱ respiratory failure of chronic obstructive pulmonary diseases were divided into two groups： death group and control group, based on the effects of treatment. The two groups were analyzed in clinical symptoms and arterial blood gas analysis. Results The death group had 58 patients （59. 8% ）, and the control group had 39 patients （40.2%）. The age of the death group was older than that in the control group. The degree of malnutrition, disturbance of consciousness, acidosis and hypercapnia in the death group were higher than those in control group. Conclusion The age, malnutrition, disturbance of consciousness, acidosis and hypercapnia could impact the prognosis of type- Ⅱ respiratory failure of chronic obstructive pulmonary. The drug treatment had better effect on the patients who have pH 〉 7.20, PaCO2 〈 90 mmHg, light disturbance of consciousness and no major malnutrition. The curative effect should be evaluated timely. The patients who have no effect after the treatment should be given mechanical ventilation. For those who have pH 〈7.20, PaCO2 〉 90 mmHg, severe disturbance of consciousness and malnutrition, they should be allowed to use mechanical ventilation when they are given medication treatment.
出处
《临床肺科杂志》
2007年第5期447-448,共2页
Journal of Clinical Pulmonary Medicine
关键词
慢性阻塞性肺疾病
呼吸衰竭
预后
治疗学
chronic obstructive pulmonary disease
respiratory failure
prognosis therapeutics
