目的 探讨人机协调管理对策在无创正压通气治疗慢性阻塞性肺病急性加重期(AECOPD)伴Ⅱ型呼吸衰竭中的地位.方法 分析76例无创正压通气治疗AECOPD伴Ⅱ型呼吸衰竭患者的资料,观察其症状、呼吸频率、心率、血氧饱和度、血气分析、情绪反应、不适反应等.结果 血气改善者61例,呼吸频率下降者60例,氧饱和度维持在90％左右者62例,咽干5例,腹胀3例,发生人机不协调者21例(其中通过调整参数、增加舒适性、消除紧张恐惧情绪、延长监测时间而继续应用者15例,停止者3例,中转有创治疗者3例).结论 人机协调管理是保证无创正压通气治疗AECOPD伴Ⅱ型呼吸衰竭取得成功的关键.%Objective To explore the effect of management and countermeasures for coordination between patient and ventilator on the treatment of acute exacerbation of chronic obstructive pulmonary disease combined with type II respiratory failure by noninvasive positive pressure ventilation. Method Materials of 76 AECOPD patients with type II respiratory failure were analyzed, and their symptoms, respiratory frequency, heart rate, saturation of blood oxygen, blood gas analysis, emotional response and adverse reactions were observed. Results Blood gas improved in 61 cases, respiratory frequency decreased in 60 cases, oxygen saturation maintained at around 90% in 62 cases; 5 patients had dry throat, 3 patients had abdominal distension; 21 patients had incoordination between patient and ventilator (among 21 patients, 15 patients continued to use ventilator after adjusting the parameters, increasing comfort, eliminating adverse emotions such as fear and tension and prolonging monitoring time, 3 patients discontinued the treatment, and the other 3 patients had to receive invasive treatment). Conclusion Management in coordination between patient and ventilator is the key to ensure the successful noninvasive positive pressure ventilation therapy for AECOPD combined with type II respiratory failure.
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