呼吸指数监测对慢性阻塞性肺疾病急性加重期合并呼吸衰竭治疗效果评估价值

Value assessment of respiratory index monitoring on treatment effect of respiratory failure in acute exacerbation of chronic obstructive pulmonary disease

目的探讨呼吸指数监测对慢性阻塞性肺疾病急性加重期(AECOPD)合并呼吸衰竭治疗效果的评估价值。方法 90例AECOPD合并呼吸衰竭按照治疗前动脉血氧分压(PaO2)水平分为轻度组24例、中度组48例,重度组18例。观察3组治疗前后动脉二氧化碳分压(PaCO2)、肺泡气氧分压(PAO2)、PaO2、呼吸指数(RI)和肺泡—动脉氧分压差(PA-aO2)。结果 3组治疗后各项指标较治疗前均改善,中度和重度AECOPD组功能衰竭器官发生率和病死率均高于轻度,且重度组高于中度,差异均有统计学意义(P<0.05)。结论 RI能够反映AECOPD合并呼吸衰竭患者的疾病发展状态,并可以将其作为预测此类患者疾病预后的指标之一。

Objective To investigate the value of assessment of respiratory index （RI） monitoring on treatment effect of respiratory failure in acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. Methods 90 cases of pa- tients with AECOPD were divided into mild group （24 cases）, moderate group （48 cases） and severe group（ 18 cases） ac- cording to the PaO2 level before treatment. The arterial carbon dioxide pressure before and after treatment （ PaCO2 ）, alveolar oxygen partial pressure （ PAO2 ）, arterial partial pressure of oxygen （PaO2 ）, RI and alveolar arterial oxygen tension difference （ PA-aO2 ） were examined and calculated. Results After treatment, the indicators of 3 groups were improved compared with before treatment,the incidence of organ failure and morality in moderate group and severe group were higher than that of the mild group, and the severe group was higher than that of the moderate group, the differences were statistically significant （P 〈 0.05）. Conclusion RI can reflect the condition of the patients with AECOPD complicated with respiratory failure, and can be used as one of the index to predict the prognosis of the disease in these patients.