溴化异丙托品在慢性阻塞性肺疾病撤机中应用价值探讨

Effect of ipratropium bromide on ventilation weaning in COPD patients

目的:了解增加溴化异丙托品(IB)吸入剂量在撤机困难的中重度慢性阻塞性肺疾病(COPD)病人中的应用价值。方法:观察17例在吸入常用剂量(80μg.次-1)IB的情况下撤机失败的中重度COPD患者撤机期间吸入较大剂量(120μg.次-1)IB后的情况。结果:17例病人均成功撤机,2、吸入120μgIB后病人脱机时的动脉血气指标优于吸入80μg IB后,病人气促程度(Borg评分)、呼吸频率及心率也低于吸入80μg IB后(P<0.01),且无明显毒副反应出现。结论:撤机期内使用较大剂量的IB有助于因气道阻力因素影响撤机的中重度阻塞性肺通气功能障碍的COPD病人撤除呼吸机。

AIM： To study the effect of increasing ipratropium bromide （IB） dosage in the morderated to severe degree COPD patients with difficultly ventilation weaning. METHODS： Observed the effects of high dosage （ 120 μg one time） ipratropium bromide in 17 patients with morderated to severe degree COPD who were fail to ventilation weaning at giving the routine dose （80μg one time） ipratropium bromide. RESULTS： All 17 patients were weaned ventilator successfully. The patients＇ indexes of artery blood gas analysis with giving high dosage IB were higher than those with routine dosage IB, the patients＇ modify Borg scores and respiration rates, heart rates with high dosage IB were lower than those with routine dosage IB（P 〈 0.01）, no further side effect for increasing IB dosage was observed. CONCLUSION：When the expiratory resistance becomes the most important factor of delaying ventilation weaning, giving a high dosage IB during ventilation weaning period may help morderate to severe degree COPD patients weaning the ventilator.