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COPD合并急性呼吸衰竭时,通常表现病势危重、病情复杂,并与心肺功能衰竭或低血容量等鉴别困难。本文应用Swan-Gang导管对10例COPD合并急性呼吸衰竭患者进行了床边PCWP监测,其中4例PCWP低于正常,补充血容量后病情好转;3例PCWP正常,循环方面无需特殊处理;另3例PCWP偏高者,及时采取了减轻左心负荷,保护心肌等措施,防止了左心衰竭。作者初步体会:在COPD合并急性呼吸衰竭患者的抢救中,进行PCWP监测将有助于鉴别诊断和指导治疗。
When COPD is complicated by acute respiratory failure, it usually presents with critically ill conditions, complicated conditions, and difficulties in differentiating from cardiopulmonary failure or hypovolemia. In this paper, PCWP monitoring was performed in 10 patients with COPD complicated with acute respiratory failure by Swan-Gang catheterization. Among them, PCWP was lower than normal in 4 patients and the condition improved after blood volume was added. 3 patients had normal PCWP and no special treatment was needed in circulation. Case of PCWP high, promptly taken to reduce the left heart load, myocardial protection and other measures to prevent the left heart failure. The authors first realized: In the rescue of COPD patients with acute respiratory failure, the PCWP monitoring will help differentiate the diagnosis and guide the treatment.