Kabakov A I
Ross Med Zh. 1992(5-12):10-4.
Seventy-eight patients aged 16-78 (48 males and 30 females) in whom COB ran with respiratory insufficiency stage II and III (51 and 27 patients, respectively) and cor pulmonale stage II-A, II-B and III (28, 26 and 8 patients, respectively) received normal-pressure oxygen for 10 min. Posttreatment examinations were performed for pulmonary function, acid and alkaline reactions, oxygen metabolism and blood flow rate. The frequency and intensity of PaCO2 rise in COB patients on oxygen therapy are shown to correlate with severity of restrictive respiratory insufficiency (RRI) and hypoxemia, to relate to reduced capacity of oxygenated hemoglobin for CO2 transport, being independent of the lost hypoxemic stimulus on the respiratory center. Elevated PaCO2 in COB patients on oxygen therapy is not a contraindication to its administration, though dictates its short duration (10-15 min 1-2 times an hour). Complete intolerance to oxygen therapy arose in 5.1% of the COB patients with manifest RRI (VC of due VC being 21.1 +/- 4.13%) and hypoxemia (% HBO2 being 52.6 +/- 8.01%). In effective treatment these patients diminished RRI and restored tolerance to oxygen therapy.
78例年龄在16 - 78岁之间的患者(48例男性,30例女性),其中慢性阻塞性肺病(COB)合并II期和III期呼吸功能不全的患者分别为51例和27例,合并II - A期、II - B期和III期肺心病的患者分别为28例、26例和8例,接受了10分钟的常压吸氧。治疗后进行了肺功能、酸碱反应、氧代谢和血流速度检查。结果显示,COB患者吸氧治疗时PaCO₂升高的频率和强度与限制性呼吸功能不全(RRI)和低氧血症的严重程度相关,与氧合血红蛋白运输二氧化碳的能力降低有关,且独立于呼吸中枢失去的低氧刺激。COB患者吸氧治疗时PaCO₂升高并非吸氧的禁忌证,尽管这要求吸氧时间短(每小时1 - 2次,每次10 - 15分钟)。5.1%有明显RRI(肺活量占预计肺活量的百分比为21.1±4.13%)和低氧血症(氧合血红蛋白百分比为52.6±8.01%)的COB患者对吸氧治疗完全不耐受。在有效治疗中,这些患者的RRI减轻,对吸氧治疗的耐受性恢复。