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Analysis of the Effect of Non-Invasive Positive Pressure Ventilation in Emergency Treatment of Severe Bronchial Asthma with Respiratory Failure
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作者 Hua Liu 《Journal of Clinical and Nursing Research》 2024年第6期58-63,共6页
Objective:This study aims to evaluate the clinical efficacy of non-invasive positive pressure ventilation(NIPPV)in patients with severe bronchial asthma combined with respiratory failure.Methods:90 patients with sever... Objective:This study aims to evaluate the clinical efficacy of non-invasive positive pressure ventilation(NIPPV)in patients with severe bronchial asthma combined with respiratory failure.Methods:90 patients with severe bronchial asthma combined with respiratory failure between September 2022 and December 2023 were selected for the study and randomly divided into the experimental group(NIPPV-assisted treatment)and the control group.The differences between the two groups were compared in terms of total effective rate of treatment,days of clinical symptom disappearance,days of hospitalization,lung function indexes,incidence of adverse reactions,and quality of life.Results:Patients in the experimental group had a significantly higher total effective rate of treatment(97.78%)than the control group(75.56%).In terms of pulmonary function indexes,patients in the experimental group showed significant improvement after treatment,especially the increase in forced expiratory volume and forced vital capacity,while these improvements were not as obvious in the control group.In addition,the incidence of adverse reactions was significantly lower in the experimental group than in the control group,suggesting that the application of NIPPV is relatively safe.Quality of life assessment also showed that patients in the experimental group had significantly better quality of life than the control group after treatment.Conclusion:This study demonstrated the effectiveness of NIPPV as an adjunctive treatment for severe bronchial asthma combined with respiratory failure.NIPPV can improve lung function,reduce the incidence of adverse effects,increase the overall effectiveness of the treatment,and contribute to the improvement of patients'quality of life.Therefore,NIPPV should be regarded as an effective and safe treatment in clinical management,especially in patients with severe bronchial asthma combined with respiratory failure,where its application has potential clinical significance. 展开更多
关键词 non-invasive positive pressure ventilation Adjunctive therapy Respiratory failure Severe bronchial asthma combined with respiratory failure Outcome assessment
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Effects of pulmonary surfactant combined with noninvasive positive pressure ventilation in neonates with respiratory distress syndrome
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作者 Ze-Ning Shi Xin Zhang +2 位作者 Chun-Yuan Du Bing Zhao Shu-Gang Liu 《World Journal of Clinical Cases》 SCIE 2024年第23期5366-5373,共8页
BACKGROUND Neonatal respiratory distress syndrome(NRDS)is one of the most common diseases in neonatal intensive care units,with an incidence rate of about 7%among infants.Additionally,it is a leading cause of neonatal... BACKGROUND Neonatal respiratory distress syndrome(NRDS)is one of the most common diseases in neonatal intensive care units,with an incidence rate of about 7%among infants.Additionally,it is a leading cause of neonatal death in hospitals in China.The main mechanism of the disease is hypoxemia and hypercapnia caused by lack of surfactant AIM To explore the effect of pulmonary surfactant(PS)combined with noninvasive positive pressure ventilation on keratin-14(KRT-14)and endothelin-1(ET-1)levels in peripheral blood and the effectiveness in treating NRDS.METHODS Altogether 137 neonates with respiratory distress syndrome treated in our hospital from April 2019 to July 2021 were included.Of these,64 control cases were treated with noninvasive positive pressure ventilation and 73 observation cases were treated with PS combined with noninvasive positive pressure ventilation.The expression of KRT-14 and ET-1 in the two groups was compared.The deaths,complications,and PaO_(2),PaCO_(2),and PaO_(2)/FiO_(2)blood gas indexes in the two groups were compared.Receiver operating characteristic curve(ROC)analysis was used to determine the diagnostic value of KRT-14 and ET-1 in the treatment of NRDS.RESULTS The observation group had a significantly higher effectiveness rate than the control group.There was no significant difference between the two groups in terms of neonatal mortality and adverse reactions,such as bronchial dysplasia,cyanosis,and shortness of breath.After treatment,the levels of PaO_(2)and PaO_(2)/FiO_(2)in both groups were significantly higher than before treatment,while the level of PaCO_(2)was significantly lower.After treatment,the observation group had significantly higher levels of PaO_(2)and PaO_(2)/FiO_(2)than the control group,while PaCO_(2)was notably lower in the observation group.After treatment,the KRT-14 and ET-1 levels in both groups were significantly decreased compared with the pre-treatment levels.The observation group had a reduction of KRT-14 and ET-1 levels than the control group.ROC curve analysis showed that the area under the curve(AUC)of KRT-14 was 0.791,and the AUC of ET-1 was 0.816.CONCLUSION Combining PS with noninvasive positive pressure ventilation significantly improved the effectiveness of NRDS therapy.KRT-14 and ET-1 levels may have potential as therapeutic and diagnostic indicators. 展开更多
关键词 Pulmonary surfactant non-invasive positive pressure ventilation Neonatal respiratory distress syndrome Keratin-14 ENDOTHELIN-1
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Effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe pneumonia 被引量:1
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作者 Chang-Hao Yao Zhao-Hua Dai Rui-Li Chai 《Journal of Hainan Medical University》 2017年第22期87-90,共4页
Objective: To discuss the effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe p... Objective: To discuss the effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe pneumonia. Methods: A total of 68 patients with COPD complicated by severe pneumonia who were treated in the hospital between November 2015 and April 2017 were collected, retrospectively analyzed and then divided into the group A (n=35) who received noninvasive positive pressure ventilation and the group B (n=33) who received lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation. The differences in arterial blood gas and serum index levels were compared between the two groups before and after treatment. Results: Before treatment, there was no statistically significant difference in arterial blood gas index levels as well as serum contents of inflammatory mediators, stress hormones and myocardial enzyme spectrum indexes between the two groups. After treatment, arterial blood gas indexes PH and PaO2 levels of group B were higher than those of group A;serum inflammatory mediators HMGB1, PCT and hs-CRP contents were lower than those of group A;serum stress hormones Cor, AngⅠ and AngⅡcontents were lower than those of group A;serum myocardial enzyme spectrum indexesα-HBDH and cTn-Ⅰ contents were lower than those of group A. Conclusion: Lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation can effectively optimize the arterial blood gas levels, reduce systemic inflammatory stress state and protect the myocardial function of patients with COPD complicated by severe pneumonia. 展开更多
关键词 COPD Severe PNEUMONIA non-invasive positive pressure ventilation Lung LAVAGE VIA FIBER BRONCHOSCOPE
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Non-Invasive Positive Pressure Ventilation (NIPPV) in the Pregnant Patient: A Case Series
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作者 Carlos Montufar-Rueda Agnès Ditisheim +5 位作者 Alfredo F. Gei Rolando Pinilla Eddie Dinh Jair Vélez Brenda Castillo Luis Farias 《Open Journal of Obstetrics and Gynecology》 2020年第11期1563-1572,共10页
<strong>Rationale: </strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Acute respiratory failur... <strong>Rationale: </strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Acute respiratory failure is an uncommon complication of pregnancy. However, it is the most frequent organ dysfunction associated with obstetric admissions to an intensive care unit. The obstetric population is a different group due to its physiology and the presence of the fetus that lacks evidence in the literature within the subject of ventilatory support. Noninvasive positive pressure ventilation (NIPPV) is often avoided due to the lack of knowledge on the safety and efficacy of this modality. </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Currently,</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> there are no guidelines for the management of respiratory failure in pregnancy. </span><b><span style="font-family:Verdana;">Objectives: </span></b><span style="font-family:Verdana;">To provide evidence in support of the use of NIPPV as a safe and reasonable modality for pregnant patients with respiratory failure. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">We retrospectively reviewed medical records of 29 pregnant patients of the Obstetric Critical Care Unit of a tertiary hospital in Panamá City who received NIPPV from 2013 to 2015. Failure to response was defined as the lack of increase in the </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">pa</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">O</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">/FiO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> ratio or clinical deterioration 6 hours after initiating NIPPV. Demographics, indication for NIPPV, duration of treatment, as well as maternal and fetal outcomes were collected. </span><b><span style="font-family:Verdana;">Measurements</span></b> <b><span style="font-family:Verdana;">and</span></b> <b><span style="font-family:Verdana;">Main</span></b> <b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Mean age was 28.4 ± 6 years, mean body mass index 27.4 ± 3.3, and mean gestational age at admission was 30</span><sup><span style="font-family:Verdana;">5/7</span></sup><span style="font-family:Verdana;"> ± 5 weeks. Twenty-four patients (82.8%) met the criteria for acute lung injury (ALI) and an additional two (6.9%) for acute respiratory distress syndrome (ARDS). The mean duration of ventilation was 50.6 ± 17.27 hours. Statistically significant differences were noted between the </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">pa</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">O</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">/FiO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> ratios in failure and successful patients within 2 hours of NIPPV therapy (P = 0.007) and </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">pa</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">O</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">/FiO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> ratio within 6 hours of NIPPV therapy (P = 0.03). Success was defined when the patient was administered NIPPV, resulting in an improvement (increase in </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">p</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">a/FiO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> ratio) of her ventilatory parameters. Three patients (10.3%) failed to respond to NIPPV and needed to be converted to invasive mechanical ventilation. Patients who required intubation had a longer duration of ICU stay (P = 0.006) and overall hospital stay (P = 0.03). None of patients presented aspiration during NIPPV therapy. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The current series is the largest report of pregnant patients requiring ventilatory support who received NIPPV as first line of therapy. This report shows the usefulness of this ventilation modality, avoiding intubation with its risks, of a significant number of patients, especially ventilator-associated pneumonia.</span></span></span></span> 展开更多
关键词 Respiratory Support during Pregnancy ARDS in Pregnancy ALI in Pregnancy ventilatory Support non-invasive positive pressure ventilation
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The Value of Positive Pressure Ventilations for Clients in Acute Respiratory Distress as a Result of Cardiac and Pulmonary Issues
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作者 Patrick O’Connell 《Open Journal of Respiratory Diseases》 2015年第2期50-54,共5页
Objective: Research was conducted to examine benefits to using non-invasive ventilation (NIV) or continuous positive airway pressure (CPAP) early in the treatment of respiratory distress caused by pulmonary edema, chr... Objective: Research was conducted to examine benefits to using non-invasive ventilation (NIV) or continuous positive airway pressure (CPAP) early in the treatment of respiratory distress caused by pulmonary edema, chronic obstructive pulmonary disease (COPD) and asthma. Limitations to successful NIV and CPAP therapy were evaluated to determine how prolonged initiation of treatment may lead to hypoxemia (decreased oxygen in the blood) and hypercapnia (increased carbon dioxide in the blood) resulting in poor outcomes. Method: Reviews of literature from nursing and allied health data bases (CINAHL and ProQuest) with terms pulmonary edema, positive pressure device and non-invasive ventilation from 2010 to 2014 were used. Studies were conducted in the hospital and prehospital settings. Results: The literature search located 7 articles from CINAHL and 25 articles from ProQuest. A total of 6 of these articles were analyzed. Additional sources of data were obtained from Ignatavicius and Workman (2013) Medical-Surgical Nursing Patient-Centered Collaborative Care 7th edition and American Journal of Nursing (02/2013) Volume 113: 2. Conclusion: All of the articles concluded that early initiation of continuous positive airway pressure ventilations in the short-term was beneficial;however, late initiation of therapy required additional interventions. The studies indicated that early use of positive airway pressure in acute respiratory distress improved breath rate, heart rate and blood pressure. The use of positive airway pressure for respiratory distress may decrease the need for endotracheal intubation. 展开更多
关键词 Continuous positive AIRWAY pressure non-invasive ventilation Acute PULMONARY EDEMA ASTHMA Chronic OBSTRUCTIVE PULMONARY Disease PREHOSPITAL Hospital
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Long-term non-invasive positive pressure ventilation in severe stable chronic obstructive pulmonary disease: a meta-analysis 被引量:10
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作者 CHEN Hong LIANG Bin-miao XU Zhi-bo TANG Yong-jiang WANG Ke XIAO Jun YI Qun SUN Jian FENG Yu-lin 《Chinese Medical Journal》 SCIE CAS CSCD 2011年第23期4063-4070,共8页
Background The evidence for non-invasive positive pressure ventilation (NIPPV) used in patients with severe stable chronic obstructive pulmonary disease (COPD) is insufficient. The aim of the meta-analysis was to ... Background The evidence for non-invasive positive pressure ventilation (NIPPV) used in patients with severe stable chronic obstructive pulmonary disease (COPD) is insufficient. The aim of the meta-analysis was to assess the treatment effects of long-term NIPPV on gas change, lung function, health-related quality of life (HRQL), survival and mortality in severe stable COPD patients. Methods Randomized controlled trials (RCTs) and crossover studies comparing the treatment effects of NIPPV with conventional therapy were identified from electronic databases and reference lists from January 1995 to August 2010. Two reviewers independently assessed study quality. Data were combined using Review Manager 5.0. Both pooled effects and 95% confidence intervals were calculated. Results Five RCTs and one randomized crossover study with a total of 383 severe stable COPD patients were included NIPPV improved gas change significantly when using a higher inspiratory positive airway pressures. The weighted mean difference (WMD) for the partial pressure of carbon dioxide in artery (PaCO2) was -3.52 (-5.26, -1.77) mmHg and for the partial pressure of oxygen in artery (PaO2) 2.84 (0.23, 5.44) mmHg. There were significant improvements in dyspnea and sleep quality, but gained no benefits on lung function. The standardized mean difference (SMD) for the forced expiratory volume in 1 second (FEV1) was 0.00 (0.29, 0.29). And the benefits for exercise tolerance, mood, survival and mortality remained unclear. Conclusions Patients with severe stable COPD can gain some substantial treatment benefits when using NIPPV, especially improvements in gas change, dyspnea and sleep quality. Studies of high methodological quality with large population, especially those based on a higher inspiratory positive airway pressures are required to provide more evidences. 展开更多
关键词 pulmonary disease chronic obstructive non-invasive positive pressure ventilation META-ANALYSIS
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Need for oxygen therapy and ventilatory support in premature infants in a hospital in Southern Brazil 被引量:2
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作者 Amanda Meier Kelser de Souza Kock 《World Journal of Critical Care Medicine》 2022年第3期160-168,共9页
BACKGROUND Prematurity in newborns is a condition that is associated with worse hospital outcomes when compared to birth to term.A preterm infant(PI)is classified when gestational age(GA)<37 wk.AIM To analyze progn... BACKGROUND Prematurity in newborns is a condition that is associated with worse hospital outcomes when compared to birth to term.A preterm infant(PI)is classified when gestational age(GA)<37 wk.AIM To analyze prognostic indicators related to the use of oxygen therapy,noninvasive ventilation(continuous positive airway pressure)and mechanical ventilation(MV)in PI.METHODS This is a retrospective cohort.The sample was composed of PIs from a private hospital in southern Brazil.We included neonates with GA<37 wk of gestation in the period of January 1,2018 to December 31,2018.For data collection,electronic records were used in the Tasy Philips^(TM)system,identifying the variables:maternal age,type of birth,prenatal information,GA,Apgar score,birth weight,neonatal morbidities,vital signs in the 1st hour at birth,need for oxygen therapy,continuous positive airway pressure and MV,hospitalization in the neonatal intensive care unit,length of stay and discharge or death.RESULTS In total,90 PI records were analyzed.The median(p25-p75)of GA was 34.0(31.9-35.4)wk,and there were 45(50%)males.The most common morbidity among PIs was the acute respiratory discomfort syndrome,requiring hospitalization in the neonatal intensive care unit in 76(84.4%)cases.The utilization rate of oxygen therapy,continuous positive airway pressure and MV was 12(13.3%),37(41.1%)and 13(14.4%),respectively.The median(p25-p75)length of stay was 12.0(5.0-22.2)d,with 10(11.1%)deaths.A statistical association was observed with the use of MV and GA<28 wk,lower maternal age,low birth weight,Apgar<8 and neonatal deaths.CONCLUSION The identification of factors related to the need for MV in prematurity may help in the indication of a qualified team and technologies to promptly meet the unforeseen events that may occur after birth. 展开更多
关键词 PREMATURE Continuous positive airway pressure Artificial respiration non-invasive ventilation
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Clinical Study on Respiratory Medicine Treatment of Chronic Obstructive Pulmonary Disease Combined with Respiratory Failure
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作者 Jianhua Yu 《Journal of Clinical and Nursing Research》 2024年第5期293-298,共6页
Objective:To explore the respiratory medicine treatment methods for treating chronic obstructive pulmonary disease(COPD)combined with respiratory failure.Methods:70 cases of COPD patients with combined respiratory fai... Objective:To explore the respiratory medicine treatment methods for treating chronic obstructive pulmonary disease(COPD)combined with respiratory failure.Methods:70 cases of COPD patients with combined respiratory failure admitted to our hospital from January 2021 to January 2023 were selected as the study subjects,and randomly divided into the control group and the experimental group,each with 35 cases.The control group received only conventional treatment,and the experimental group received non-invasive positive pressure ventilation,and the treatment effects and changes in the levels of IL-18,hs-CRP,and CES2 inflammatory factors were observed and evaluated in the two groups.Results:There was no significant difference between the general data of the two groups(P>0.05);after treatment,the total effective rate of clinical efficacy of the observation group(91.43%)was significantly higher than that of the control group(71.43%),and the difference showed a significant correlation(P<0.05);after treatment,the level of inflammatory factor of the observation group was significantly reduced compared with that of the control group,and the difference showed a highly significant correlation(P<0.001).Conclusion:The non-invasive positive pressure ventilation treatment program significantly improves the therapeutic effect,effectively controls the level of inflammatory factors,and improves the health status of patients when dealing with patients with chronic obstructive pulmonary disease accompanied by respiratory failure,showing a good clinical application prospect. 展开更多
关键词 Chronic obstructive pulmonary disease Respiratory failure non-invasive positive pressure ventilation Therapeutic effect Inflammatory factor
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慢性阻塞性肺疾病并Ⅱ型呼吸衰竭稳定期患者的家庭无创正压通气治疗 被引量:5
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作者 陈乐蓉 雷建平 《中国医药》 2011年第9期1062-1064,共3页
目的 探讨家庭无创正压通气在慢性阻塞性肺疾病(COPD)并Ⅱ型呼吸衰竭稳定期患者治疗中的应用价值.方法 30例COPD急性加重期并Ⅱ型呼吸衰竭患者经住院治疗通气功能改善后,根据患者经济情况并征得患者同意进行分组,其中10例为家庭无创... 目的 探讨家庭无创正压通气在慢性阻塞性肺疾病(COPD)并Ⅱ型呼吸衰竭稳定期患者治疗中的应用价值.方法 30例COPD急性加重期并Ⅱ型呼吸衰竭患者经住院治疗通气功能改善后,根据患者经济情况并征得患者同意进行分组,其中10例为家庭无创正压通气组,只进行家庭无创正压通气治疗,每日2~3次,每次2~4 h;10例为家庭氧疗组,只进行家庭氧疗和常规药物治疗;另外10例为常规治疗组,只进行常规药物治疗.记录所有患者出院时和治疗前后、出院后1年血气指标,统计所有患者出院后1年中的平均住院次数、住院费用,统计死亡人数计算病死率.结果 家庭无创通气组患者治疗1年前后pH、PaCO2、PaO2分别为(7.24±0.06)、(7.34±0.07),(78±9)、(52±7)mm Hg(1 mm Hg=0.133 kPa),(50±7)、(63±5)mm Hg,治疗前后比较,差异均有统计学意义(均P<0.01).家庭无创通气患者年平均住院次数和住院费用分别为(1.98±0.53)次/年、(4.62±1.51)万元/年,与家庭氧疗组[(4.03±0.91)次/年、(12.86±8.26)万元/年)]比较差异有统计学意义(均P<0.01);而家庭氧疗组年平均住院次数和住院费用与常规治疗组[(4.32±0.68)次/年、(16.71±3.22)万元/年)]比较,差异无统计学意义(P>0.05).结论 家庭无创通气治疗是减少COPD并Ⅱ型呼吸衰竭患者住院次数、改善血气指标、提高生活质量的好方法. 展开更多
关键词 肺疾病 慢性阻塞性 家庭无创正压通气 呼吸衰竭
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慢性阻塞性肺疾病稳定期并呼吸衰竭患者长期家庭无创间歇正压通气的疗效观察 被引量:4
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作者 槐永军 纪同运 林育红 《临床军医杂志》 CAS 2014年第6期560-562,共3页
目的观察长期家庭无创间歇正压通气(NIPPV)对慢性阻塞性肺疾病(COPD)稳定期并呼吸衰竭患者的疗效。方法将COPD稳定期并呼吸衰竭患者100例,分为NIPPV组50例和对照组50例,在病情稳定期,治疗组给予长期家庭NIPPV及常规治疗,对照组仅给予常... 目的观察长期家庭无创间歇正压通气(NIPPV)对慢性阻塞性肺疾病(COPD)稳定期并呼吸衰竭患者的疗效。方法将COPD稳定期并呼吸衰竭患者100例,分为NIPPV组50例和对照组50例,在病情稳定期,治疗组给予长期家庭NIPPV及常规治疗,对照组仅给予常规治疗。长期随访,观察两组患者在治疗后血气指标中pH、PaCO2、PaO2的变化,对比两组患者治疗后每年COPD急性加重次数、平均住院费用、平均住院时间的变化。结果 NIPPV组患者在治疗后较对照组的pH、PaO2明显增高(P<0.05),PaCO2明显降低(P<0.05),每年COPD急性加重次数、平均住院费用及平均住院时间均显著降低(P<0.05)。结论长期家庭NIPPV是治疗COPD稳定期并呼吸衰竭患者的有效措施。 展开更多
关键词 慢性阻塞性肺疾病 稳定期 呼吸衰竭 家庭无创正压通气
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不同治疗方法对晚期慢性阻塞性肺疾病呼吸衰竭患者预后的影响 被引量:2
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作者 韩其政 亓梅 +1 位作者 赵慧 曹德志 《中国医师进修杂志(内科版)》 2007年第8期22-24,共3页
目的探讨晚期慢性阻塞性肺疾病(COPD)患者临床缓解期最佳的治疗方法。方法将47例晚期COPD患者分为三组:A组为不能或不接受家庭氧疗和家庭无创正压通气(NPPV)者;B组为出院后在医生指导下进行长期家庭氧疗者;C组为能在医生指导下... 目的探讨晚期慢性阻塞性肺疾病(COPD)患者临床缓解期最佳的治疗方法。方法将47例晚期COPD患者分为三组:A组为不能或不接受家庭氧疗和家庭无创正压通气(NPPV)者;B组为出院后在医生指导下进行长期家庭氧疗者;C组为能在医生指导下进行长期家庭NPPV加长期家庭氧疗,且能很好耐受者。回顾性对比分析三组患者1年内再住院率、再插管率及病死率。结果B组患者1年内的再住院率、再插管率及病死率较A组分别降低了38.4%、17.3%和18.0%,而C组患者较B组患者又降低了8.0%、35.3%和29.4%,三组患者的再住院率、再插管率及病死率比较,差异均有统计学意义(P〈0.05)。结论长期家庭氧疗和长期家庭NPPV能显著降低晚期COPD患者的再住院率、再插管率和病死率,长期家庭氧疗加长期家庭NPPV治疗效果最好。 展开更多
关键词 慢性阻塞性肺疾病 呼吸衰竭 长期家庭氧疗 长期家庭无创正压通气
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长期家庭无创正压通气治疗重度慢性阻塞性肺疾病稳定期的疗效观察 被引量:5
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作者 范敏娟 赵国厚 +2 位作者 沈雯 温林俏 王蜀昆 《医学信息(中旬刊)》 2011年第4期1255-1256,共2页
目的:观察在重度慢性阻塞性肺疾病稳定期患者进行长期家庭无创正压通气治疗的疗效。方法:重度慢性阻塞性肺疾病(COPD)患者47例,随机分为治疗组27例和对照组20例,在病情的稳定期,治疗组给予长期家庭无创正压通气及常规治疗,对照组20例仅... 目的:观察在重度慢性阻塞性肺疾病稳定期患者进行长期家庭无创正压通气治疗的疗效。方法:重度慢性阻塞性肺疾病(COPD)患者47例,随机分为治疗组27例和对照组20例,在病情的稳定期,治疗组给予长期家庭无创正压通气及常规治疗,对照组20例仅给予常规治疗。随访2年,观察两组治疗前后的住院次数、住院时间、住院费用、呼吸困难程度、血气、肺功能及病死率的变化。结果:两组患者的住院次数、住院时间、住院费用、呼吸困难程度、血气、肺功能及病死率有显著差异(P<0.05)。结论:重度慢性阻塞性肺疾病患者稳定期采用长期家庭无创正压通气治疗有利于改善病情。 展开更多
关键词 慢性阻塞性肺疾病 长期家庭无创正压通气 临床应用
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慢性阻塞性肺疾病患者长期家庭无创正压通气疗效观察 被引量:2
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作者 李雪华 李报春 +1 位作者 张宇飞 安晓静 《老年医学与保健》 CAS 2012年第6期376-378,共3页
目的观察在重度慢性阻塞性肺疾病稳定期患者长期家庭无创正压通气(NPPV)治疗的疗效。方法慢性阻塞性肺疾病(COPD)合并慢性呼吸衰竭患者45例,随机分为治疗组20例和对照组25例,在病情的稳定期,治疗组给予长期家庭无创正压通气及常... 目的观察在重度慢性阻塞性肺疾病稳定期患者长期家庭无创正压通气(NPPV)治疗的疗效。方法慢性阻塞性肺疾病(COPD)合并慢性呼吸衰竭患者45例,随机分为治疗组20例和对照组25例,在病情的稳定期,治疗组给予长期家庭无创正压通气及常规治疗,对照组仅给予常规治疗。随访2~3年,观察两组治疗前后的每年平均急性加重次数、平均住院时间、平均住院费用、呼吸困难程度、血气指标及病死率的变化。结果两组患者的每年急性加重次数及病死率差异无统计学意义(P〉O.05),住院时间、住院费用、血气指标中pH值均有显著差异沪〈0.05),呼吸困难程度、PCO:有显著性差异(P〈0.01)。结论长期家庭无创正压通气治疗是重度慢性阻塞性肺疾病合并慢性呼吸衰竭稳定期患者有效的治疗手段。 展开更多
关键词 慢性阻塞性肺疾病 慢性呼吸衰竭 长期家庭无创正压通气
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Efficacy of high-flow nasal cannula on acute exacerbation of chronic obstructive pulmonary disease: A meta-analysis 被引量:1
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作者 Ying-Ming Sun Min Zhang +2 位作者 Na Sun Zhi Guan Ying Wang 《Medical Data Mining》 2019年第4期142-149,共8页
Objective:To systematically evaluate the efficacy and feasibility of high-flow nasal cannula(HFNC)on patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:Systematic searches on Pub... Objective:To systematically evaluate the efficacy and feasibility of high-flow nasal cannula(HFNC)on patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:Systematic searches on PubMed,Web of Science,the Cochrane Library,Embase,CBM(Chinese Biomedicine Database),CNKI(China National Knowledge Infrastructure),Wanfang Database and VIP were performed for randomized controlled trials(RCTs)which explored the effects of HFNC on patients with AECOPD.The retrieval time was from the establishment of each database to July 2019.RevMan5.3 software was used for statistical analysis.Results:A total of 12 articles were included,involving 812 patients.The results showed that:(1)Compared with conventional oxygen therapy,HFNC could improve patients'arterial partial oxygen pressure(PaO2)(MD=12.70,95%CI(7.00,18.40),Z=4.37,P<0.0001),reduce partial arterial blood carbon dioxide(PaCO2)(MD=-10.99,95%CI(-14.42,-7.55),Z=6.26,P<0.00001)and reduce endotracheal intubation rate(OR=0.19,95%CI(0.04,0.93),Z=2.05,P=0.04),shorten the hospitalization time(SMD=-0.74,95%CI(-1.11,-0.37),Z=3.95,P<0.0001).(2)Compared with non-invasive positive pressure ventilation,it has fewer adverse reactions(OR=0.18,95%CI(0.09,0.35),Z=5.08,P<0.00001)and shorter hospital stay(SMD=-0.57,95%CI(-0.90,-0.23),Z=3.33,P=0.0009).Conclusion:HFNC can improve the patients’hypoxia symptoms and CO2 retention,reduce the rate of tracheal intubation,and alleviate adverse reactions.However,Limited by the quality and region of the included studies,more high-quality are needed to test it. 展开更多
关键词 High-flow nasal cannula AECOPD non-invasive positive pressure ventilation Conventional oxygen therapy META-ANALYSIS
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慢性阻塞性肺疾病并发慢性呼吸衰竭患者长期家庭无创正压通气治疗的成本效益分析 被引量:12
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作者 韩其政 亓梅 +1 位作者 贾曰林 赵慧 《国际呼吸杂志》 2011年第5期348-350,共3页
目的探讨长期家庭无创正压通气治疗慢性阻塞性肺疾病并发慢性呼吸衰竭的临床经济学意义。方法共选择34例慢性阻塞性肺疾病并发慢性呼吸衰竭患者,治疗组17例,应用长期家庭无创通气治疗;对照组17例,常规治疗。观察比较治疗组治疗后与... 目的探讨长期家庭无创正压通气治疗慢性阻塞性肺疾病并发慢性呼吸衰竭的临床经济学意义。方法共选择34例慢性阻塞性肺疾病并发慢性呼吸衰竭患者,治疗组17例,应用长期家庭无创通气治疗;对照组17例,常规治疗。观察比较治疗组治疗后与治疗前及治疗组治疗后与对照组的年平均疾病急性发作次数、年平均住院次数、年平均住院天数及年平均医疗花费情况,将购买家用呼吸机的支出作为治疗组的额外成本,对治疗组治疗后与治疗前、治疗组治疗后与对照组的年平均花费进行成本效益分析。结粜治疗组治疗后患者的年平均疾病急性发作次数、平均住院次数、平均住院天数、平均医疗费用较治疗前及对照组均显著减少(P〈0.01);治疗组治疗后较治疗前及对照组年平均节省的医疗费用(B)分别为5.51万元和5.48万元,购买呼吸机的平均费用(C)为2.3万元,B/C值分别为2.40和2.38,有明显的临床经济学意义。结论长期家庭无创正压通气治疗慢性阻塞性肺疾病并发慢性呼吸衰竭可明显降低总的医疗费用支出。 展开更多
关键词 慢性阻塞性肺疾病 家庭无创通气 临床经济学 成本-效益比
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家庭无创正压通气治疗慢性阻塞性肺疾病的临床操作 被引量:3
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作者 罗祖金 詹庆元 《中国实用内科杂志》 CAS CSCD 北大核心 2009年第3期290-292,共3页
关键词 慢性阻塞性肺疾病 家庭无创正压通气 临床操作
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慢性阻塞性肺疾病患者应用家庭无创机械通气1年的疗效观察 被引量:8
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作者 周宁 曹洁 +3 位作者 邓园 豆市英 陈宝元 汤华 《国际呼吸杂志》 2011年第9期677-681,共5页
目的探讨稳定期合并高碳酸血症的极重度慢性阻塞性肺疾病(COPD)患者应用家庭无创机械通气的疗效。方法将患者分为无创通气组20例,对照组26例,其中两组患者的性别、年龄、病程、吸烟史、肺功能及血气分析指标差异均无统计学意义。随... 目的探讨稳定期合并高碳酸血症的极重度慢性阻塞性肺疾病(COPD)患者应用家庭无创机械通气的疗效。方法将患者分为无创通气组20例,对照组26例,其中两组患者的性别、年龄、病程、吸烟史、肺功能及血气分析指标差异均无统计学意义。随访期为1年,分别测量比较患者在出院时和出院1年后的第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、匹兹堡睡眠质量指数量表(PSQI)评分、圣·乔治呼吸问卷(SGRQ)评分,动脉血二氧化碳分压(PCO2)、动脉血氧分压(PO2)、pH值,呼吸困难分级和6分钟步行距离(6WMD),并观察患者1年内因急性加重而住院的次数。结果①稳定期合并高碳酸血症的两组极重度COPD患者,其FEV1、FVC、PO2、pH值在治疗前后差异均无统计学意义(P〉0.05),但两组患者的PCO2在治疗前后差异有统计学意义(P〈0.05),其中无创通气组的PCO2较出院时降低(P〈0.05),对照组的PCO2较出院时升高(P〈0.05)。②两组患者的SGRQ评分差异均有统计学意义(P〈0.05)。无创通气组治疗1年后的MMRC评分比治疗前有所降低(P〈0.05),而对照组差异无统计学意义(P〉0.05)。对照组患者出院1年的6WMD较出院时明显下降(P〈0.05),无创通气组则较出院时差异无统计学意义(P〉0.05)。两组患者出院1年后的PSQI与出院时相比差异均无统计学意义(P〉0.05)。③无创通气组经无创通气后其住院次数与1年前相比明显下降(P〈0.05),对照组则呈现上升趋势(P〈0.05)。结论稳定期合并高碳酸血症的极重度COPD患者,长期家庭无创正压通气对患者的肺功能无明显的改善,但是可以降低患者PCO2,一定程度上改善缺氧,提高生活质量,减少住院次数,提高运动耐力,缓解呼吸困难,但对于睡眠质量没有明显的改变。 展开更多
关键词 慢性阻塞性肺疾病 家庭无创正压通气 肺功能 动脉血气 圣·乔治呼吸问卷评分
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