| 引用本文： |
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刘杨,马少林,沈桢巍.无创与有创通气治疗慢性阻塞性肺疾病急性加重的疗效分析[J].同济大学学报（医学版）,2010,31(1):69-72. [点击复制]
- LIU Yang,MA Shao-lin,SHEN Zhen-wei.Comparison of non-invasive and invasive ventilation on acute exacerbations of chronic obstructive pulmonary diseases[J].同济大学学报（医学版）,2010,31(1):69-72. [点击复制]
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| 摘要: |
| 目的评价无创与有创通气对于慢性阻塞性肺疾病急性加重（acute exacerbations of chronic obstructive pulmonary diseases, AECOPD）患者的治疗效果。方法59例AECOPD患者按早期使用机械通气方式随机分为有创组（28例）和无创组（3l例），观察患者机械通气前后血气分析指标，Glasgow昏迷评分（Glasgowcomascale，GCS），以及机械通气时间。结果有创组机械通气2h后，pH、m02明显上升，paC02明显下降（P〈0．05）；无创组机械通气‘2h后，pa0：明显上升（P〈0．05），pH及paC02无明显改变（P〉0．05）。使用机械通气12h后，无创组paC02与pH均明显好转（P〈0．05）。有创组机械通气时间较无创组更长（尸〈0．05）。对无创组进行亚组分析，最终需要改有创通气的患者在早期入院时血气分析较可坚持使用无创通气的患者有更低的pH及更高的paC02（P〈O．05）。结论早期有创通气对AECOPD患者血气分析改善优于无创通气；机械通气12h后，两种通气方式对血气指标的改善作用相似。有创通气者可能需更长机械通气时间。早期p．CO。、pH的水平可作为评价患者最终是否需要插管的指标。 |
| 关键词: 慢性阻塞性肺疾病 急性发作期 无创机械通气 有创机械通气 血气分析 Glasgow昏迷评分 |
| DOI：10.3969/j.issn1008-0392.2010.01.016 |
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| 基金项目: |
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| Comparison of non-invasive and invasive ventilation on acute exacerbations of chronic obstructive pulmonary diseases |
| LIU Yang,MA Shao-lin,SHEN Zhen-wei |
| (Dept.of Center ICU,East Hospital,Tongji University School of Medicine,Shanghai 200120,China) |
| Abstract: |
| Objective To evaluate the effects of non - invasive ventilation and invasive ventilation on acute exacerbations of chronic obstructive pulmonary diseases ( AECOPD ) . Methods Fifty -nine patients were randomly divided into 2 groups accroding the methods of mechanical ventilation, non -invasive ventilation ( NIVG ) group ( 31 patients ) and invasive ventilation ( IVG ) group ( 28 patients ) . The result of blood gas analysis, Glasgow coma scale ( GCS ) and mechanical ventilation time were observed and compared. Results After 2 hours of ventilation, pH and paCO2 increased ( P <0.05 ) and paO2 decreased significantly in patients with IVG ( P <0.05 ) ; while paO2 increased significantly in patients with NIVG ( P<0.05 ) , but pH and paCO2 had no obviously changes ( P>0.05 ) . After 12 hours of ventilation, paCO2 and pH of patients in NIVG group were better P 0.05 . The ventilation time in IVG group was longer than that in NIVG group. On the subgroup analysis of NIVG, tho s e p atients needed invasi ve ventil ation 1 ater h ad a lower pH and higher paC02 at the b eginning ( %<0.0 5).C onclusion Comp ared with NIVG, IVG h as a b etter effect on pH, pa02 and phave almost same effects . Patients in IVG group need a longer ventilation time. The levels of paC02 and pH at the beginning can be good indices on whether the patient needs intubation. |
| Key words: chronic obstructive pulmonary disease acute exacerbation noninvasive ventilation non-invasive ventilation blood gas analysis Glasgow coma scale |
