允许性高碳酸血症在慢性阻塞性肺疾病急性加重期呼吸衰竭时的临床应用

目的探讨允许性高碳酸血症(PHC)在慢性阻塞性肺疾病(COPD)急性加重期呼吸衰竭时的治疗作用.方法将33例COPD急性加重期呼吸衰竭患者随机分为:小潮气量(7ml/kg)16例作为观察组,常规潮气量(12ml/kg)17例作为对照组,对观察组实施PHC通气.结果观察组动脉血PaCO2明显高于对照组,但气道压降低,相关并发症减少,机械通气时间缩短,撤机成功率高.结论COPD急性加重期呼吸衰竭患者采取PHC通气是行之有效的肺保护性策略之一.

The clinical application of permissive hypercapnia ventilation in COPD patients with acute respiratory failure

Objective To evaluate the clinical application of permissive hypercapnia ventilation in COPD patients with acute respiratory failure.Methods Thirty three COPD patients requiring mechanical ventilation were randomly divided into two groups:the trial group with low tidal volume ventilation(7ml/kg,n=16)and the control group with routine tidal volume ventilation(12ml/kg,n =17).Permissive hypercapnia ventilation was used in the trial group.Results The values of arterial PaCO 2 in the trial group were significantly higher than those of control group.However,the trial group had markedly lower airway pressure,fewer ventilation-induced complications,shorter duration of mechanical ventilation and higher successful rates of ventilation withdrawal.Conclusion The permissive hypercapnia ventilation appears to be of value in treatment of COPD patients with acute respiratory failure.[