慢性阻塞性肺病急性期病人对呼吸机依赖的原因及策略.pdfVIP

·90 · Journal of Emergency Medicine , April 1999 , Vol8 , No2 　 ·论著· 慢性阻塞性肺病急性期病人对 呼吸机依赖的原因及对策 ( 附22 例报告) 李立斌 　夏怡 　崔巍 　　【摘要】目的 : 探讨慢性阻塞性肺病 (COPD) 急性期患者对机械通气产生依赖的原因 , 以 及相应的治疗方法。方法 : 对 3 年来收入我院 ICU 36 例行机械通气的 COPD 急性期病人进行回顾 性研究。结果 : 在 36 例 COPD 急性期病人中 , 22 例出现了对呼吸机的依赖 , 发生率约 61 % , 最 后 16 例成功撤机 , 占73 % , 6 例因严重并发症死亡 , 占27 % 。感染、营养不良及呼吸机应用不 当是造成对呼吸机依赖的主要原因。14 例出现营养不良或加重 , 列居所有并发症之首。结论 : 加强感染控制 , 合理的营养支持 , 减少呼吸肌做功 , 以及减少并发症的发生是治疗的关键。 【关键词】慢性阻塞性肺病 　呼吸机依赖 Causes and treatment of ventilator dependent patients with COPD in acute respiratory failure Li Libin , Xia Yi , Cui Wei. Intensive Care Unit , 2nd Affiliated Hospital of Zhejiang Medical University , Hangzhou 310009 【Abstract 】Aim : To study causes and treatment of ventilator dependent patients with chronic obstructive pulmonary disease (COPD) in acute respiratory failure. Methods : Retrospective studies were performed on 36 cases of COPD with acute respiratory failure who enrolled ICU in our hospital during past 3 years. Results : Twentytwo patients developed ventilator dependent with an incidence 61 %. Among them , 16 patients (73 %) were successfully weaned. 6 patients died of serious complications. Infections , malnutrition and im proper mechanical ventilation were main factors responsible for the dependency. Malnutrition ( 14 cases) was the most commm factor. Conclusion : We consider , therefore , effective infection control , reasonable nutri tional support , lessening the work of respiratory muscles as well as minimizing the occurrence of complications are the keys of successful treatment. 【Key words】CO