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目的总结分析慢性阻塞性肺疾病(COPD)并发呼吸衰竭的诊断与治疗经验。方法回顾性分析22例慢性阻塞性肺疾病(COPD)并发呼吸衰竭的临床资料。结果 14例经常规抗感染、解痉平喘、化痰止咳等保守治疗均获成功,无效者行机械通气及支气管镜吸痰,支气管肺泡灌洗8例,无效2例。死因为呼吸机相关性肺炎、高气压伤、感染性休克、顽固性心衰、严重电解质紊乱和多脏器功能不全。结论慢性阻塞性肺疾病(COPD)并发呼吸衰竭,常规治疗结合机械通气、支气管镜下吸痰、支气管肺泡灌洗并根据痰或支气管肺泡灌洗液行细菌培养及药敏试验选用抗生素是救治成功的关键,及时治疗原发病和处理合并症,是有效的治疗方法 。
Objective To summarize the experience of diagnosis and treatment of chronic obstructive pulmonary disease (COPD) complicated with respiratory failure. Methods The clinical data of 22 patients with chronic obstructive pulmonary disease (COPD) complicated with respiratory failure were retrospectively analyzed. Results Of the 14 cases, conservative treatment such as conventional anti-infection, antispasmodic and anti-asthmatic and phlegm and relieving cough were successful. All those who were ineffective were treated with mechanical ventilation and bronchoscopy and sputum aspiration, bronchoalveolar lavage in 8 cases and ineffective in 2 cases. Death due to ventilator-associated pneumonia, high barotrauma, septic shock, refractory heart failure, severe electrolyte imbalance and multiple organ dysfunction. Conclusion Chronic obstructive pulmonary disease (COPD) complicated by respiratory failure, conventional treatment combined with mechanical ventilation, bronchoscopy sputum aspiration, bronchoalveolar lavage and sputum or bronchoalveolar lavage fluid bacterial culture and drug sensitivity test selection of antibiotics is the treatment of success The key to timely treatment of primary disease and treatment of complications, is an effective treatment.