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作者就伴有高碳酸血症型呼吸衰竭慢性阻塞性肺疾病(COPD)患者的临床病程进行了研究。 入院时动脉血气分析(ABG)是呼吸性酸中毒(即PaCO_2≥50mmHg,pH<7.35),进入内科加强治疗病房(MICU)接受治疗的COPD患者138例次,其中接受气管插管通气治疗74(56例)例次(54％)(插管组),未插管只采用药物治疗64(47例)例次(药物组)。而同期不伴有高碳酸血症型呼吸衰竭的COPD患者气管插管率为33％(40/122例次)(P<0.01)。插管组和药物组的肺功能测定结果无显著差异。但插管组的急性生理和长期健康评估Ⅱ积分(APACHE Ⅱ)显著高于药物组,分别为18±5和16±4(P<0.01);插管组的血白细胞和血清尿素氮水平也显著大于药物组,分别为
The authors studied the clinical course of patients with chronic obstructive pulmonary disease (COPD) accompanied by hypercapnia respiratory failure. Arterial blood gas analysis (ABG) at admission was respiratory acidosis (ie, PaCO 2 ≥ 50 mmHg, pH <7.35) and was admitted to the MICU for 138 episodes of treatment, with endotracheal intubation ventilated to treat 74 56 cases) (54%) (intubation group), and only 64 (47 cases) cases were given intubated drugs (drug group). In the same period, the rate of endotracheal intubation was 33% (40/122) in patients with COPD without hypercapnia (P <0.01). There was no significant difference in lung function test results between intubation and drug groups. However, the acute physiology and long-term health assessment II score (APACHE II) in intubation group was significantly higher than that in the drug group (18 ± 5 and 16 ± 4, respectively) (P <0.01). The levels of leukocyte and serum urea nitrogen Significantly greater than the drug group, respectively