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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 evaluate the effects of mechanical ventilation on the changes of red blood cells in patients with chronic obstructive pulmonary disease (COPD). Methods: The case report form was used to collect the blood analysis and blood gas analysis of 67 COPD patients admitted to ICU from 2004 to 2008 in our hospital. The database was set up: ① To determine 67 patients with COPD before mechanical ventilation, ventilation for 1 day, ventilation 7 Days after the red blood cell count, hemoglobin, hematocrit and partial pressure of oxygen, to assess the impact of mechanical ventilation on red blood cells in COPD patients. ② According to the prognosis is divided into survival group and death group: compared two groups before ventilation and ventilation 1 day, 7 days after erythrocyte analysis of changes in value. ③ The age group of 65 was divided into the younger age group and the older age group. The changes of red blood cells before and 1 day and 7 days of ventilation were compared between the two groups. Results: (1) The erythrocyte count, hemoglobin and hematocrit decreased significantly with time after mechanical ventilation, and the partial pressure of oxygen increased obviously (P <0.05). ② The changes of erythrocytes in the survival group and the death group before and after ventilation were significantly different with time. ③ There was no significant difference in the changes of erythrocytes between the elderly group and the younger group before and after ventilation. Conclusions: The RBC count, hemoglobin and hematocrit in COPD patients decreased significantly with the increase of time after mechanical ventilation treatment. The changes of prognosis of patients with COPD should be removed by intubation as soon as possible to shorten the duration of invasive mechanical ventilation, shorten ICU and total length of hospital stay, and be effective Improve the treatment effect, reduce the cost of treatment, is a certain clinical practical value of the treatment program.