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作者对20例因支气管感染致病情加重的COPD 患者给予间歇负压通气治疗。于负压通气前和后6小时分别测量血气和最大吸气压(MIP),随机以常规治疗日作为对照.结果如下:负压通气后MIP 的均值(SD)从68.1(21.5)增加到74.8(20)cmH_2O;动脉二氧化碳分压(PaCO_2)从60.6(12.2)降至50.9(8.9)mmHg;但动脉氧分压(PaO_2)变化很小,从48.4(7.4)降至47.6(8.2)mmHg。而对照治疗日动脉血气和MIP 则无明显变化.6例患者对负压通气耐受性较差,负压通气后血气和MIP 无明显改变.能耐受负压通气的14例患者较6例耐受差者MIP 和A-aDo_2明显增加,PaCO_2明显下降.在研究期间,未观察到上呼吸道阻塞的临床证据.作者认为,在治疗期间让患者放松,一些患者可较好地适应该技术.另外,呼吸肌与负压通气仪同步可能易使患者耐受,而自主呼吸与呼吸机不同步可能是患者不舒
The author of intermittent negative pressure ventilation was given to 20 COPD patients with exacerbations due to bronchial infection. Blood gas and maximum inspiratory pressure (MIP) were measured before and 6 hours after negative pressure ventilation, and were randomly assigned to a routine treatment day as a control. The results were as follows: The mean MIP (SD) after negative pressure ventilation increased from 68.1 (21.5) to 74.8 (20) cmH_2O; PaCO_2 decreased from 60.6 (12.2) to 50.9 (8.9) mmHg; however, PaO_2 changed little from 48.4 (7.4) to 47.6 (8.2) mmHg. While there was no significant change in arterial blood gas and MIP in the control treatment day.All patients had poor tolerance to negative pressure ventilation and no significant changes in blood gas and MIP after negative pressure ventilation.Fifteen patients who tolerated negative pressure ventilation had 6 cases Patients with poor tolerance increased significantly in MIP and A-aDo_2, while PaCO 2 decreased significantly. No clinical evidence of upper airway obstruction was observed during the study. The authors concluded that patients may be relaxed during treatment and that some patients may better accommodate the technique. In addition, the respiratory muscles and negative pressure ventilator synchronization may be easily tolerated patients, spontaneous breathing and ventilator out of sync may be patients uncomfortable