中国全科医学2013，Vol.16Issue(2)：147-150,4.DOI:10.3969/j.issn.1007-9572.2013.01.046
慢性阻塞性肺疾病急性加重合并Ⅱ型呼吸衰竭患者使用无创正压通气成功的临床预测因素研究
Outcome Predictors for Non-invasive Positive Pressure Ventilation in Patients with Acute Exacerbations of Chronic Obstructive Pulminary Disease Complicated by Type Ⅱ Respiratory Failure
谭伟 1孙龙凤 1代冰 1赵洪文 1康健1
作者信息
- 1. 110001辽宁省沈阳市,中国医科大学附属第一医院呼吸疾病研究所内科ICU
- 折叠
摘要
Abstract
Objective To summarize the clinical outcome predictors for non - invasive positive pressure ventilation ( NIPPY ) in patients with acute exacerbations of chronic obstructive pulminary disease ( AECOPD ) complicated by type II respiratory failure. Methods The clinical and laboratory data of 84 patients with AECOPD complicated by type II respiratory failure who used NIPPV in our hospital from January 2011 to June 2012 were retrospectively analyzed. The clinical features and the blood gas indicators before and 2 and 4 - 6 h after NIPPV usage were compared between the success group and failure group using multi-variate Logistic regression analysis. Results Among these 84 patients, NIPPV was successful in 64 patients ( 76% ) and failed in 20 patients ( including 15 patients who changed to invasive mechanical ventilation and 11 cases of death ). Univariate analysis showed that, compared with the failure group, the success group had significantly lower APACHE II score, higher T - cell subsets ( CD3+ , CD4+ , CD8+ ), and higher PaCO, before the initiation of NIPPV; However, the pH and PaCO, were more remarkably improved in the success group than in the failure group 4~6 hours after NIPPV. Multivariate Logistic regression analysis revealed that APACHE II score [P =0.044, OR 1.796, 95% CI ( 1.886, 13.009 )] was an independent outcome predictor for NIPPV in patients with AECOPD complicated by type II respiratory failure. Conclusion For the patients with AECOPD complicated by type II respiratory failure patients, lower APACHE II score, higher T - cell subsets on admission and the more changed pH and PaCO, at the 4 - 6 h after NIPPV may predict better outcomes after NIPPV.关键词
慢性阻塞性肺疾病急性加重/无创正压通气/Ⅱ型呼吸衰竭Key words
AECOPD/Noninvasive positive pressure ventilation/Type II respiratory failure分类
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谭伟,孙龙凤,代冰,赵洪文,康健..慢性阻塞性肺疾病急性加重合并Ⅱ型呼吸衰竭患者使用无创正压通气成功的临床预测因素研究[J].中国全科医学,2013,16(2):147-150,4.
