无创正压机械通气治疗支气管扩张症合并呼吸衰竭的回顾性分析_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 刘海涛 , 何敬堂 , 邱志红 , 于哲 , 闫利红 , 李志娟 , 张景 , 王军民

河北医科大学附属华北油田公司总医院呼吸内科(河北任丘 062552);

Corresponding author：

刘海涛, Email: huayouhuxineike@126.com

Keywords：

无创正压机械通气; 支气管扩张症; 呼吸衰竭; 动脉血气分析

DOI：

10.7507/1671-6205.2014020

Video：

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目的观察支气管扩张症合并呼吸衰竭患者应用无创正压机械通气(NPPV)治疗前后各项生理指标的变化,评价其疗效。方法选择2010年1月至2011年12月华北油田公司总医院收治的应用无创正压机械通气治疗的支气管扩张症合并呼吸衰竭患者36例,比较治疗前后患者的心率、呼吸频率(RR)、pH值、动脉血二氧化碳分压(PaCO₂)、动脉血氧分压(PaO₂)、氧合指数(PaO₂/FiO₂)、辅助呼吸肌评分、呼吸困难分级、第1秒用力呼气容积占预计值百分比(FEV₁%pred)、第1秒用力呼气容积/用力肺活量比值(FEV₁/FVC)、插管率和病死率。结果经无创正压机械通气治疗后,患者的心率、RR、PaCO₂、辅助呼吸肌评分和呼吸困难分级均明显下降,pH值、PaO₂、PaO₂/FiO₂、FEV₁%pred、FEV₁/FVC均明显上升,与治疗前比较差异具有统计学意义(P＜0.05)。2例患者因病情恶化行有创机械通气治疗,插管率5.56%,其中1例患者死亡。结论合理选择应用NPPV可以改善支气管扩张症合并呼吸衰竭患者的肺通气功能。

Citation： 刘海涛, 何敬堂, 邱志红, 于哲, 闫利红, 李志娟, 张景, 王军民. 无创正压机械通气治疗支气管扩张症合并呼吸衰竭的回顾性分析. Chinese Journal of Respiratory and Critical Care Medicine, 2014, 13(1): 84-86. doi: 10.7507/1671-6205.2014020 Copy

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2. Hill AT, Pasteur M, Cornford C,et al. Primary care summary of the British Thoracic Society Guideline on the management of non-cystic fibrosis bronchiectasis.Prim Care Respir J,2011,20:135-140.
3. Martínez García MÁ,Máiz Carro L,Catalán Serra P.Treatment of non-cystic fibrosis bronchiectasis.Arch Bronconeumol,2011,47:599-609.
4. Woodhead M,Blasi F,Ewig S,et al.Guidelines for the management of adult lower respiratory tract infections--full version.Clin Microbiol Infect,2011,17 Suppl 6:E1-E59.
5. 戴冰冰,徐健,刘春芳,等.早期应用无创通气治疗慢性阻塞性肺疾病急性加重疗效观察.中国呼吸与危重监护杂志,2008,7:140-141.
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7. 成人支气管扩张症诊治专家共识编写组.成人支气管扩张症诊治专家共识.中华结核和呼吸杂志,2012,35:485-492.
8. Díaz O,Bégin P,Andresen M,et al.Physiological and clinical effects of diurnal noninvasive ventilation in hypercapnic COPD.Eur Respir J,2005,26:1016-1023.
9. Ozsancak A,D'Ambrosio C,Hill NS.Nocturnal noninvasive ventilation.Chest,2008,133:1275-1286.

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无创正压机械通气治疗支气管扩张症合并呼吸衰竭的回顾性分析

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