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-  2016 

慢性阻塞性肺疾病无创通气期间高浓度吸氧对二氧化碳分压的影响

DOI: doi:10.7507/1671-6205.2016078

Keywords: 慢性阻塞性肺疾病, 急性加重, 无创通气, 吸氧浓度, 二氧化碳潴留

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Abstract:

目的 观察二氧化碳潴留的慢性阻塞性肺疾病(简称慢阻肺)急性加重期患者于无创通气(NIV)期间高浓度吸氧的安全性。 方法 纳入2013年3月至2015年8月在哈励逊国际和平医院呼吸和危重症医学科住院的56例慢阻肺急性加重患者。慢阻肺急性加重患者经低吸氧浓度(FiO2<0.5)NIV治疗病情稳定后,将FiO2增加到1.0并持续40 min,观察试验前后潮气量、呼吸频率、分钟通气量、Glasgow评分、动脉血气分析和指氧饱和度(SpO2)的变化。 结果 有二氧化碳潴留的慢阻肺急性加重患者在NIV期间经高FiO2吸氧后,PaO2由(83±14)mm Hg显著增加至(165±41)mm Hg(P<0.001);SpO2由(92.4±3.1)%显著增加至(97.8±1.9)%(P<0.001);而PaCO2试验前后分别为(72±15)mm Hg和(72±14)mm Hg,差异无统计学意义(P=0.438),潮气量、呼吸频率、分钟通气量、Glasgow评分等参数亦无明显变化(P>0.05)。 结论 慢阻肺急性加重患者NIV治疗期间,在病情稳定的基础上,短期增加FiO2不会加重二氧化碳潴留

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