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        west china medical publishers
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        find Author "QIAN Jiao" 2 results
        • Isolated nocturnal oxygen desaturation in pre-discharge inpatients with chronic obstructive pulmonary disease: prevalence and risk factors

          Objective To investigate the prevalence and risk factors of isolated nocturnal oxygen desaturation (INOD) in pre-discharge inpatients with chronic obstructive pulmonary disease (COPD). Methods Totally 431 inpatients with COPD in this department were screened during January to June in 2017, in which pre-discharge inpatients without daytime hypoxia were enrolled in this study. Portable and wearable oximeter was used to record whole night oxygen saturation, pulse, hand movement of the inpatients within two days before being discharged. The clinical characters and symptoms, resting daytime artery gas analysis results, spirometry results, Epworth Sleepiness Score (ESS), Pittsburgh Sleep Quality Index (PSQI) were recorded and compared between INOD and non-INOD patients. Moreover, these data were furtherly compared between patients with or without suspected COPD-SAHS overlap syndrome (OS) to reveal the differences in clinical features. Logistics regression was used to find out independent predictors. Results One hundred and six pre-discharge inpatients without daytime hypoxia were screened out and out of them, 44 patients (41.5%) were proven with INOD. Patients with INOD presented lower daytime SaO2 [(91.8±1.1)% vs. (94.4±1.5)%, P<0.05], moreover, the patients with suspected OS had a higher yearly exacerbation frequency (2.1±0.6 per yearvs. 1.4±0.4 per year, P<0.05), higher ESS score (10.5±2.7vs. 5.1±2.5, P<0.05) and PSQI (12.8±4.4vs. 7.4±3.1, P<0.05). Conclusions Even in pre-discharge COPD inpatients without daytime hypoxia, there is 41.5% of them suffering from unrevealed INOD. Lower daytime oxygen saturation and higher ESS indicate probable INOD and with higher exacerbation risk in OS patients. To screen out INOD in pre-discharge COPD is of clinical value and in need of attention.

          Release date:2017-11-23 02:56 Export PDF Favorites Scan
        • The Therapeutic Study of Average Volume Assured Pressure Support Noninvasive Ventilation in Overweight Chronic Obstructive Pulmonary Disease Patients with Acute Ventilatory Failure

          目的 比較無創雙水平正壓通氣(BiPAP)平均容積保證壓力支持(AVAPS)模式與同步/時間控制(S/T)模式在肥胖的慢性阻塞性肺疾病(COPD)患者并發急性Ⅱ型呼吸衰竭中的治療作用。 方法 選取2012年3月-2013年6月入院治療且體質量指數(BMI)>25 kg/m2的COPD發生急性Ⅱ型呼吸衰竭患者36例,按數字隨機表法分為AVAPS組與S/T組。兩組的基礎治療相同,AVAPS組采用飛利浦偉康V60呼吸機BiPAP AVAPS模式進行無創通氣治療,S/T組采用相同機型BiPAP S/T模式治療。分別比較兩組患者治療1、6、24、72 h的格拉斯高昏迷(GCS)評分變化、血氣分析結果、呼吸機監測數據。 結果 AVAPS組患者在最初治療的6 h內GCS評分高于S/T組[1 h:(13.2 ± 0.6)、(11.9 ± 0.6) 分,P<0.05;6 h:(13.8 ± 0.5)、(12.1 ± 0.6)分,P<0.05];24 h內的動脈血氣酸堿度pH值改善[1 h:7.31 ± 0.03、7.26 ± 0.02,P<0.05;6 h:7.37 ± 0.05、7.31 ± 0.04,P<0.05];24 h:7.40 ± 0.04、7.33 ± 0.03,P<0.05]及二氧化碳分壓下降[1 h:(65.2 ± 5.1)、(69.5 ± 4.1)mm Hg(1 mm Hg=0.133 kPa),P<0.05;6 h:(61.4 ± 4.2)、(66.7 ± 4.3) mm Hg,P<0.05;24 h:(58.2 ± 4.5)、(64.3 ± 5.4) mm Hg,P<0.05)]優于S/T組,24 h內淺快呼吸指數低于S/T組[1 h:(35.2 ± 8.1)、(62.8 ± 13.2)次/(min·L),P<0.05];6 h(33.4 ± 7.8) 、(54.8 ± 11.6)次/(min·L),P<0.05],同時,減少了額外的人工參數調整次數[3.4 ± 1.1、1.2 ± 0.6),P<0.05] 結論 對超重的COPD合并急性Ⅱ型呼吸衰竭患者采用AVAPS模式進行無創通氣治療,較S/T模式能更快地恢復意識水平,更快地降低血二氧化碳分壓、改善pH值,同時減少了呼吸治療師的人工操作次數。

          Release date:2016-08-26 02:09 Export PDF Favorites Scan
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