高碳酸血症在慢性呼吸衰竭患者长期吸氧治疗的研究

Clinical study of Hypercapnia in patients with chronic respiratory failure

目的高碳酸血症在慢性肺病长期吸氧治疗患者的临床研究。方法研究对象是2000年1月至2006年1月的60例成人慢性呼吸衰竭同年龄层患者,年龄从60岁至75岁,平均65.2岁。男性39例,女性21例。A组为经过长期吸氧治疗后死亡的患者,B组为经过长期吸氧治疗后病情好转患者,我们对A组、B组的血碳酸检验结果进行统计分析比较,分析是否存在差异。结果因呼吸衰竭死亡18例(30%),3例因其它原因死亡(5%),39例好转(65%)。18例因呼吸衰竭死亡的患者长期吸氧治疗时二氧化碳分压:8例二氧化碳分压45≤PaCO2<55mmHg,6例二氧化碳分压55≤PaCO2<55mmHg,4例患者二氧化碳分压PaCO2>55mmHg。39例好转患者长期吸氧治疗时二氧化碳分压:15例二氧化碳分压45≤PaCO2<55mmHg,14例二氧化碳分压55≤PaCO2<55mmHg,10例患者二氧化碳分压PaCO2>55mmHg。经秩和检验得P=0.6928,认为A、B两组患者的二氧化碳分压PaCO2无明显差异。结论高碳酸血症不能用来预测慢性呼吸衰竭患者在进行长期吸氧治疗时的预后。因而在慢性呼吸衰竭患者在进行长期吸氧治疗时的高碳酸血症无需刻意校正至正常水平。

Objective Clinical study of Hypercapnia in patients with chronic respiratory failure. Methods The study object were 60 cases patients with chronic respiratory failure, age ranged from 60 to 75 years old, mean 65.2 years old. Male 39 cases, female patient 21 cases. Group A who died after Long-term Oxygen Therapy, Group B who became better after Long-term Oxygen Therapy. Then evaluate and analysis analyze the follow-up result. Results Group A 18 cases （30%） died of respiratory failure, 3 cases （5%） died of other reason, Group B 39 cases became better. Group A 8 cases 45≤PaCO2〈55mm Hg, 6 cases 55≤PaCO2〈55mm Hg, 4 cases PaCO2〉55mmHg. Group B： 15 cases 45≤PaCO2〈55mmHg, 14 cases 55≤PaCO2〈55mmHg, 10 cases PaCO2〉55mmHg. Group A and B have not significant difference （P=0.6928） of PaCO2 Conclusions hypercapnia should not be considered an ominous sign in patients with chronic respiratory failure during long-term oxygen therapy. Hypercapnia observed in chronic respiratory failure does not necessarily need to be corrected during long-term oxygen therapy.