标题：限制性液体管理在COPDⅡ型呼吸衰竭中的应用

      作者：林润培 1，梁伟权 2，梁红伟 1，张丹芳 1，周 凯 1，杨 莉 1
    (1.佛山市南海区第二人民医院 ICU，广东 佛山 528000；
2.佛山市第二人民医院呼吸科，广东 佛山 528000)

      卷次： 2014年25卷22期

      【摘要】 目的 探讨限制性液体管理在慢性阻塞性肺疾病(COPD)Ⅱ型呼吸衰竭中的应用效果。方法 选
择2012年7月至2014年1月佛山市南海区第二人民医院收治的70例COPDⅡ型呼吸衰竭的患者进行研究。按
照随机数表法将70例患者随机均分为观察组和对照组，每组各35例。根据患者CVP (中心静脉压)及出入量情
况进行液体的管理。观察组采用限制性的液体管理措施，对照组采用非限制性的液体管理措施。监测分析两组
患者液体管理前后的乳酸、N末端B型利钠肽原(NT-proBNP)及氧合指数，并调查记录两组患者机械通气时间。
结果 液体管理前，两组患者的CVP、乳酸、NT-proBNP及氧合指数差异均无统计学意义(P>0.05)；液体管理后，
观察组的氧合指数、NT-proBNP改善状况明显优于对照组(P<0.01)。液体管理后，观察组患者机械通气时间平均
为(10.23±3.02) d，对照组患者为(12.04±2.88) d，其差异有统计学意义(P<0.05)。结论 限制性液体管理在COPD
Ⅱ型呼吸衰竭中的应用价值较高，值得临床推广应用。

      【关键词】 限制性液体管理；COPD；呼吸衰竭；疗效

      【中图分类号】 R563 【文献标识码】 A 【文章编号】 1003—6350（2014）22—3304—03


Application of restrictive fluid management in COPD complicating respiratory failureⅡ.
LIN Run-pei 1, LIANG
Wei-quan 2, LIANG Hong-wei 1, ZHANG Dan-fang 1, ZHOU Kai 1, YANG Li 1. 1. ICU, the Second People's Hospital of
Nanhai District of Foshan City, Foshan 528000, Guagndong, CHINA; 2. Department of Respiratory, the Second People's
Hospital of Nanhai District of Foshan City, Foshan 528000, Guangdong, CHINA

【Abstract】 Objective To study the effect of restrictive fluid management in chronic obstructive pulmonary
disease (COPD) complicating respiratory failureⅡ. Methods Seventy COPD patients with respiratory failure from
July 2012 to January 2014 in the Second People's Hospital of Nanhai District of Foshan City were randomly assigned
to the experimental group and the control group. Regulated by central venous pressure and the input and output vol-
ume, the experimental group received restrictive fluid management, while the control group received non-restrictive
fluid management. The level of lactate acid, NT-proBNP, oxygenation index and time of mechanical ventilation were
compared between the two groups before and after fluid management. Results The level of lactate acid, NT-proBNP,
oxygenation index and time of mechanical ventilation before fluid management showed no statistically significant dif-
ference between the two groups (P>0.05). After restrictive fluid management, the improvements in oxygenation index
and NT-proBNP in experimental group were significantly better than the control group (P<0.01). The average duration
of mechanical ventilation was (10.23±3.02) d in experimental group and (12.04±2.88) d in the control group, with sig-
nificant difference between the two groups (t=2.566 0, P=0.012 5). Conclusion Mestrictive fluid management has
better application value for treating COPD complicating respiratory failure.

      【Key words】 Restrictive fluid management; COPD; Respiratory failure; Eficacy