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肺结核并慢性肺心病病人缓解期肺换气功能特点为低氧血症,氧离曲线略左移和肺泡通气正常。发生呼吸衰竭时的共同特点为进一步加重的低氧血症。此外,Ⅰ型呼衰氧离曲线左移,肺泡通气正常或过度;Ⅱ型呼衰与此相反。呼衰并心衰后主要影响氧合功能。呼衰发生时的氧合和肺泡通气状态在缓解组与死亡组之间无显著性差异,救治后缓解组氧合状态明显改善;死亡组与之相反。而肺泡通气的改善则因型而异。应选择PaO_2/F_1O_2、P_(50)和PaCO_2作为肺结核病人重症监护的指标。
Pulmonary tuberculosis and chronic pulmonary heart disease in patients with remission during pulmonary ventilation features hypoxemia, oxygen left slightly shifted curve and alveolar ventilation. The common feature of respiratory failure occurs when hypoxemia is further aggravated. In addition, type Ⅰ respiratory failure left oxygen curve, alveolar ventilation is normal or excessive; type Ⅱ respiratory failure and the opposite. Huff failure and heart failure mainly affect oxygenation function. Oxygenation and alveolar ventilation at the time of respiratory failure were not significantly different between the remission group and the death group, and the oxygenation status of the remission group was significantly improved after treatment. The death group was the opposite. The improvement of alveolar ventilation varies according to type. PaO_2 / F_1O_2, P_ (50) and PaCO_2 should be selected as indicators of intensive care for tuberculosis patients.