无创正压通气治疗慢性阻塞性肺疾病急性加重并高碳酸血症的疗效分析

发布时间：2019-02-19 15:05

【摘要】：目的探讨无创正压通气(NPPV)治疗慢性阻塞性肺疾病急性加重(AECOPD)合并高碳酸血症的临床疗效。方法回顾性分析2013年至2015年因COPD急性加重伴高碳酸血症(Pa CO2≥70mm Hg)入住呼吸科的57例患者,检测患者经无创正压通气治疗前后血气分析各项指标的变化及临床转归,并根据治疗前,患者动脉血p H值分为三组,p H7.25组,7.35p H≥7.25组,p H≥7.35组。结果(1)基线资料:三组年龄比较差异有统计学意义,两两比较p H7.25组与p H≥7.35组差别有统计学意义,其余组别两两相互比较,差别无统计学意义,三组中性别、神志状况、无创通气治疗前Pa CO2值、Pa O2值比较,差别无统计学意义;(2)血气指标比较:7.35p H≥7.25与p H≥7.35两组在治疗前后p H、Pa CO2和Pa O2比较,差别均有统计学意义;p H7.25组,p H在治疗前后差别有统计学意义,但Pa O2和Pa CO2在治疗前后,差别无统计学意义;(3)临床转归:三组患者治疗成功率差别无统计学意义;各组中有肺性脑病和神志清楚的患者治疗成功率差异均无统计学意义。结论 NPPV对COPD急性加重伴高碳酸血症(Pa CO2≥70 mm Hg)患者有较好的疗效,对动脉血p H偏低和\或意识障碍的患者也有较好的疗效。
[Abstract]:Objective To study the clinical effect of non-invasive positive pressure ventilation (NPV) in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with hypercapnia. Methods A retrospective analysis of 57 patients with acute exacerbation of COPD and hypercapnia (Pa CO2-70mm Hg) in the respiratory department from 2013 to 2015 were analyzed retrospectively. The changes of blood gas and the clinical outcome of the patients before and after the non-invasive positive pressure ventilation were measured. The blood p H of the patient was divided into three groups, p-H7. 25, 7. 35p H-7. 25, p-H-7.35. Results (1) Baseline data: There was a significant difference between the three groups. The difference between the two groups was statistically significant. The difference between the two groups was statistically significant. There was no significant difference in the value of PaO 2. (2) The blood gas index was compared with that of p H, Pa CO 2 and Pa 2 before and after treatment, and the difference was significant between the two groups, p H, Pa CO 2 and Pa 2. The difference of p H, Pa CO 2 and Pa 2 was significant in the treatment of p H, Pa CO 2 and Pa 2. However, there was no statistical significance between PaO 2 and Pa CO 2 before and after treatment, and (3) clinical outcome: There was no statistical significance in the treatment success rate of the three groups. Conclusion NPPV has a better therapeutic effect on patients with acute exacerbation of COPD with hypercapnia (Pa CO 2 and 70 mm Hg).
【作者单位】：山西医科大学附属山西大医院呼吸内科;
【基金】：国家自然科学基金资助项目(81470240)
【分类号】：R563.9;R589.4

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