机械通气对慢性阻塞性肺疾病患者红血球变化的影响

Effect of mechanic ventilation on red blood cells of patients with chronic obstructive pulmonary diseases

目的:评价机械通气治疗对慢性阻塞性肺疾病(COPD)患者红血球变化的影响。方法:采用病例报告表,收集我院ICU2004年-2008年收治的67例COPD行机械通气患者的血球分析及血气分析,建立数据库:①测定67例COPD患者机械通气前、通气1天、通气7天后红细胞计数、血红蛋白、红细胞压积以及氧分压值,评估机械通气对COPD患者红血球变化的影响。②根据预后分为生存组和死亡组:比较两组通气前与通气1天、7天后红血球分析变化值。③以65岁为界分为低龄组和高龄组,比较两组通气前与通气1天、7天的红血球分析变化值。结果:①机械通气后红细胞计数、血红蛋白、红细胞压积随时间均明显降低,氧分压明显升高(P<0.05)。②生存组和死亡组通气前后红血球分析变化值随时间变化有显著差异。③高龄组和低龄组通气前后红血球分析变化值无明显差异。结论:COPD患者行机械通气治疗后红细胞计数、血红蛋白、红细胞压积随时间增加明显降低,其变化影响预后,应尽早拔除气管插管,缩短有创机械通气时间,缩短ICU和总住院时间,有效改进治疗效果,降低治疗费用,是具有一定临床实用价值的治疗方案。

Objective： To investigate the changes in red blood cells after mechanic ventilation（MV） in the treatment of chronic obstructive pulmonary disease. Method： 67 cases were collected in Intensive Care Unite （ICU） in our hospital from 2004 to 2008. Comparing the values of red blood cell count, hemoglobin, haematocrit and partial pressure of carbon dioxide in artery （RBC, HGB, HCT and PaCO2） at different time points of MV, which are before MV, one day after and 7 days after MV. Comparing the variational value between survival group and nonsurvival group. Results： It is found that the values at different time points significantly decreased （P 〈 0.01 ）. Significant changes had been found about the values over time after MV between survival and nonsurvival groups. Interestingly, no significance had been found about the values between one day after MV and 7 days after MV in the aging group and young group. Conclusions： After mechanic ventilation, RBC, HGB and HCT decreased significantly over time, as a result, it is a valuable and effective project to shorten the duration of mechanical ventilation hospitalization, in order to improve the theraputic efficacy and decrease the cost of therapy.