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1.
沈剑  李艳萍  包勇  殷俊 《华西医学》2014,(5):931-932
目的探讨慢性阻塞性肺疾病(COPD)合并抑郁患者与呼吸衰竭、肺性脑病发生的关系。方法随机选取2009年10月-2011年10月住院期间COPD患者共92例,行抑郁自评量表及汉密尔顿抑郁量表测评,记录住院期间血气分析结果。结果汉密尔顿抑郁量表研究计算人选92例患者中合并抑郁患者53例,抑郁发病率57.6%,其中37例(69.8%)为中重度抑郁。COPD抑郁患者合并呼吸衰竭者33例,合并肺性脑病表现24例。呼吸衰竭、肺性脑病的发生率与COPD患者抑郁状态有关,合并抑郁状态的COPD患者发生呼吸衰竭的可能性是单纯COPD患者的2.5倍,发生肺性脑病的可能性是单纯COPD患者的1.7倍。结论COPD合并抑郁患者较单纯COPD患者易发生呼吸衰竭及肺性脑病,肺性脑病产生的神经精神异常进一步加重抑郁情绪。  相似文献   

2.
目的分析慢性阻塞性肺疾病(COPD)夜间病情特点,以便提出护理对策。方法分析149例慢性阻塞性肺疾病患者夜间病情特点,并采取以下护理措施:认真落实病情交接班制度;持续低流量吸氧;加强病情观察;保持呼吸道通畅;增加夜班护士人力等。结果COPD患者夜间病情特点包括低氧血症、易发生肺性脑病、存在睡眠呼吸障碍、气道阻塞及易发生心力衰竭。145例COPD患者病情好转出院,4例病情加重,经抢救无效死亡。结论做好COPD患者夜间病情观察和护理,可有效预防肺性脑病、右心衰竭等并发症的发生。  相似文献   

3.
目的:评价双水平无创正压通气(BiPAP)对慢性阻塞性肺疾病(COPD)并发肺性脑病治疗中的作用。方法:32例COPD并发肺性脑病患者在综合治疗基础上用BiPAP治疗观察前后血气分析与临床症状的变化。结果:28例患者治疗后血气分析与临床症状较治疗前明显改善,4例患者病情加重,2例自动出院,2例死亡。结论:BiPAP对COPD并发肺性脑病具有积极的治疗意义。  相似文献   

4.
[目的]总结脑梗死合并肺性脑病病人的护理。[方法]对16例脑梗死合并肺性脑病病人积极治疗,同时密切观察病情,加强一般护理、氧疗的护理、生活护理、心理护理及早期康复指导等。[结果]死亡3例,自动出院3例,治愈10例。[结论]加强脑梗死合并肺性脑病病人的护理,有利于预后。  相似文献   

5.
总结了31例慢性阻塞性肺疾病合并肺性脑病患者的护理,认识到慢阻肺合并肺性脑病患者的康复不仅仅取决于积极的治疗,还包括多项护理人员的密切观察及精细的护理措施,是提高临床疗效,促进患者早日康复的关键。认为对慢性阻塞性肺疾病合并肺性脑病患者采取规范的护理措施,提高临床疗效,降低了病死率,可以取得良好效果。  相似文献   

6.
目的:观察慢性阻塞性肺疾病(COPD)合并肺性脑病无创正压通气(NIPPV)治疗及护理的疗效。方法:对68例COPD合并肺性脑病患者在常规治疗基础上给予双水平无创正压通气(BiPAP)治疗,观察治疗前后患者的临床症状、动脉血气指标的变化。结果:39例6 h内意识转为清楚,12例6~12 h意识转为清楚,7例13~24 h意识转为清楚。58例治疗后动脉血气指标较治疗前改善(P<0.05),10例疗效不佳改行有创机械通气。结论:NIPPV治疗COPD并肺性脑病,能快速缓解症状,纠正呼吸衰竭,同时配合有效的护理措施,疗效肯定,值得临床推广应用。  相似文献   

7.
目的:评价双水平无创通气(BiPAP)对慢性阻塞性肺疾病(COPD)并肺性脑病的临床疗效。方法:27例COPD并肺性脑病患者在综合治疗基础上用BiPAP治疗,观察治疗前后血气分析与临床症状的变化。结果:24例患者治疗后,血气分析与临床症状较治疗前明显改善,余3例患者病情加重,1例自动出院,2例死亡。结论:BiPAP对COPD呼吸衰竭并肺性脑病具有积极的治疗意义。  相似文献   

8.
目的:探讨医院-社区-家庭护理模式用于慢性阻塞性肺疾病(COPD)患者出院后肺康复的效果。方法:以医院-社区-家庭护理模式为依据对40例COPD患者进行1年的院外肺康复护理。干预前、干预后1年进行肺功能测定和生活质量评分。结果:患者干预1年后的肺功能相关指标及生活质量较干预前有明显改善,差异具有统计学意义(P0.01)。结论:以医院-社区-家庭护理模式对COPD患者进行肺康复管理,有利于改善患者的肺功能,提高其生活质量。  相似文献   

9.
无创机械通气治疗慢性阻塞性肺疾病合并肺性脑病的护理   总被引:1,自引:0,他引:1  
总结33例慢性阻塞性肺疾病合并肺性脑病患者行无创机械通气的护理。认为严密观察患者病情,准确设置呼吸机参数,加强气道护理,做好用药护理,积极防治并发症,可提高慢性阻塞性肺疾病合并肺性脑病患者无创机械通气治疗的效果。  相似文献   

10.
慢性阻塞性肺疾病并发Wernicke脑病   总被引:2,自引:0,他引:2  
目的:熟悉慢性阻塞性肺疾病(COPD)合并Wernicke脑病的临床表现及处理原则.方法:对1例COPD并发Wernicke脑病患者进行分析,并结合文献进行讨论.结果:长期营养不良的COPD患者易继发Wernicke脑病,血气分析有利于Wernicke脑病和肺性脑病的鉴别.结论:不明原因的神经精神症状、眼球运动障碍或共济失调应警惕本病的可能,早期大剂量补充维生素B1是治疗该病的关键.  相似文献   

11.
ObjectivesThis study aimed to retrospectively assess using computed tomography pulmonary angiography (CTPA) for predicting residual pulmonary hypertension (RPH) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) after pulmonary endarterectomy (PEA).MethodsWe retrospectively analyzed data of 131 patients with CTEPH who underwent PEA in our center (2008–2015). We measured several diameters of the pulmonary artery and thoracic aorta preoperatively. We evaluated the relationship between these measurements (and their indices) and signs of RPH represented by pulmonary artery systolic pressure (PASP) estimated by echocardiography.ResultsSignificant correlations were observed between the aortopulmonary index and prediction of any residual hypertension and moderate/severe hypertension 1 year after PEA, and any residual hypertension and severe hypertension 2 years after PEA. The aortopulmonary index was significantly related to a reduction in PASP 1 year after the operation. A lower aortopulmonary index (≤0.88 for the ascending aorta and ≤0.64 for the descending aorta) predicted lower RPH.ConclusionsPreoperative CTPA parameters can be used to assess the risk of RPH after PEA. The aortopulmonary index has significant predictive value for RPH and a reduction in PASP after PEA. Lower values of the aortopulmonary index suggest a better outcome after PEA.  相似文献   

12.
An otherwise healthy 48-year-old woman presented in respiratory extremis from massive pulmonary embolism and promptly arrested. She underwent open-chest cardiopulmonary resuscitation followed by portable partial cardiopulmonary bypass and embolectomy but could not be resuscitated. Massive pulmonary embolism is frequently a desperate situation, but aggressive therapy with thrombolysis or embolectomy (in patients with contraindications to thrombolysis) may be lifesaving.  相似文献   

13.
Introduction: Percutaneous transluminal pulmonary angioplasty (PTPA) was introduced for the treatment of chronic thromboembolic pulmonary hypertension (CTEPH) in the late 20th century, and first attempts in collective patients were made in 2001 with beneficial effects but a moderate amount of complications. It was refined around 2010, and has been recently established as an effective and safe treatment.

Areas covered: The indication was originally inoperable CTEPH with peripheral lesions, but has now widened to symptomatic or hypoxic patients. The lesion is typically a meshwork-like structure of organized thrombi and is sometimes not seen as a stenosis angiographically, necessitating other means of investigation such as measurement of distal pressure. The technique to treat lesions is the same as for coronary angioplasty except in several ways.

Expert commentary: The effects of PTPA are comparable to those of surgical endarterectomy, and the complications of reperfusion pulmonary edema and vascular injury are now controlled by several strategies and based on experience.  相似文献   


14.
Postobstructive pulmonary edema (POPE; also known as negative pressure pulmonary edema) is a potentially life-threatening complication in which pulmonary edema occurs shortly after the relief of an upper airway obstruction. The incidence of POPE has been reported to be as high as 1 in 1000 general anesthetic cases and commonly presents as acute respiratory distress that requires immediate intervention. This review examines the 2 subclasses of POPE and describes the etiologic factors, pathophysiology, clinical manifestations, diagnostic criteria, and treatment strategies associated with each. The aim of this review was to equip clinicians with the knowledge base necessary to identify patients at increased risk for POPE and to expeditiously diagnose and treat this potentially catastrophic complication.  相似文献   

15.
目的探讨右下肺动脉直径联合肺动脉压力值在肺心病诊断中的应用价值。方法随机选取我院2014年6月~2016年5月49例确诊肺心病患者为肺心病组;以同期收治的诊断为慢性阻塞性肺疾病的31例患者为COPD组;以及无心肺疾病的30例就诊患者为对照组。分别使用CT测量上述各组的右下肺动脉直径,心脏彩超测量肺动脉压力,比较各组的指标变化,并分析各指标与肺心病病程的关系。结果随着肺心病病程的进展,右下肺动脉直径增大;对照组和肺心病组的主肺动脉直径及肺动脉压力值差异有统计学意义;肺心病组与COPD组、对照组组间的右下肺动脉直径/肺动脉压力值比较,差异均有统计学意义。结论右下肺动脉直径/肺动脉压力值变化与肺心病病程进展程度有关, 右下肺动脉直径/肺动脉压力值是诊断肺心病及其进程的CT监测指标。  相似文献   

16.
目的探讨肺动脉高压患者行肺动脉漂浮导管术的护理配合要点及经验。方法对12例经超声心动图诊断的肺动脉高压患者采用肺动脉漂浮导管测量肺动脉压,护理配合要点在于配合医生时注意无菌操作、密切观察压力曲线变化、准确准时记录肺动脉压、密切观察患者的生命体征及不适症状。结果 12例患者均顺利完成肺动脉漂浮导管术,8例患者确诊为肺动脉高压,无严重并发症出现。结论肺动脉漂浮导管术可明确诊断肺动脉高压,操作过程中严密的监测及护理配合可防止并发症的发生。  相似文献   

17.
Percutaneous balloon pulmonary valvuloplasty (PBPV) is the primary treatment for pulmonary valve stenosis (PVS). The study consisted of 228 children with PVS who underwent PBPV from January 2004 to October 2019 at a single center. The risk factors for ≥moderate pulmonary regurgitation (PR), residual stenosis, and restenosis were analyzed based on the baseline patient characteristics and measured value of corresponding inspection results. Among 228 patients, follow‐up results were obtained in 193 patients. The univariate analysis demonstrated that young age, low weight, small pulmonary annulus diameter, higher initial RV‐PA PSEG, increased RV/systemic pressure ratio, and severe PVS were associated with ≥moderate PR. The multivariate analysis demonstrated that higher initial RV‐PA PSEG and low weight were independently associated with ≥moderate PR, while higher initial RV‐PA PSEG was independently associated with residual stenosis and restenosis. PBPV is a preferred tre atment in PVS children with a higher success rate. Higher initial RV‐PA PSEG was a significant factor for ≥moderate PR, residual stenosis, and restenosis.  相似文献   

18.
慢性阻塞性肺疾病合并肺纤维化临床分析   总被引:2,自引:0,他引:2  
周贤梅  戴令娟  蔡后荣  侯杰 《临床荟萃》2003,18(22):1270-1272
目的 了解慢性阻塞性肺疾病合并肺纤维化的临床特点,探讨其临床意义。方法 对比分析我院1990~2002年诊断的慢性阻塞性肺疾病(COPI))合并肺纤维化14例及特发性肺纤维化(IPF)20例患者的症状、体征、X线胸片、胸部高分辨CT(HRCT)、肺功能、血气分析结果。结果 COPD合并肺纤维化及IPF在发病年龄、性剐方面无差别,而前者从发病至就诊时间明显较后者长。COPD合并肺纤维化常在慢性咳嗽基础上出现进展较快的呼吸困难及Velcro啰音,具有两种病变并存的X线及CT表现,常为混合型通气功能障碍,低氧血症明显,二氧化碳潴留则有所减轻。结论 慢性阻塞性肺疾病与肺间质纤维化具有不同的临床特点,当二者并存时,各自的特点则不明显,兼有二者的特征。  相似文献   

19.
慢性阻塞性肺疾病合并肺间质纤维化的临床研究   总被引:1,自引:0,他引:1  
陈永凤  刘巨源 《临床荟萃》2006,21(8):564-566
目的研究慢性阻塞性肺疾病(COPD)合并肺间质纤维化的临床特点及意义,并探讨其临床诊断要点.方法对近8年来临床确诊的36例COPD合并肺间质纤维化病例进行临床与影像学的回顾性分析研究,其中肺气肿合并肺纤维化11例,肺心病合并肺纤维化25例.结果 COPD合并肺间质纤维化的临床表现多数界于上述两种病变之间,胸部X线及CT兼具二者特点,肺纤维化病变在肺心病组多见.结论 COPD合并肺间质纤维化具有其独特的临床与影像学特征,其中临床症状及胸片是诊断的重要线索,高分辨率CT是临床确诊的最佳方法.  相似文献   

20.
目的:探讨肺隔离症(PS)的CT表现及特点。方法:回顾分析12例经临床病理证实的PS的CT表现,观察其位置、大小、形态、内部结构、边缘征象、外周改变及增强表现,总结其CT影像特征。结果:12例PS中,男8例,女4例,年龄最大62岁,最小2岁;平均20.21岁。10例位于左肺下叶,2例位于右肺下叶,9例叶内型,3例叶外型。影像表现6例异常的肺实质内含有充液或不充液的囊腔,3例可见囊或结节环绕的低密度区,2例见多发扩张的血管,1例示软组织密度肿块。12例对比剂增强螺旋CT扫描10例显示了病变的异常血管。结论:Ps多具肺内感染性病变影像表现。对比剂增强螺旋CT扫描是PS诊断及鉴别诊断的重要手段。  相似文献   

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