慢性阻塞性肺疾病急性加重患者的机械通气指南(13)

推荐意见19：无创正压通气是AECOPD患者早期拔管的有效手段。 [推荐级别：B级]

推荐意见20：对于支气管-肺部感染为诱发加重因素的AECOPD患者,可以肺部感染控制窗作

为有创通气与无创通气的切换点。 [推荐级别：B级]

编写人员：王辰，刘大为，席修明，邱海波，马晓春，黎毅敏，杜斌，詹庆元，解立新

参考文献

1. Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2005. .

2. Turkington PM，Elliott MW. Rationale for the use of non-invasive ventilation in chronic

ventilatory failure. Thorax, 2000, 55: 417-423.

3. International Consensus Conferences in Intensive Care Medicine: noninvasive positive

pressure ventilation in acute respiratory failure.Am J Respir Crit Care Med, 2001, 163: 283-291.

4. RossiA , Polese G, Brandi G, et al. Intrinsic positive end expiratory pressure (PEEPi).

Intensive Care Med, 1995, 21: 522-536.

5. 孔维民, 王辰, 杨媛华, 等. 外源性呼气末正压对慢性阻塞性肺疾病患者呼吸功的影响.

中华内科杂志, 2001, 40: 385-389.

6. Ninane V, Yernault JC, Troyer AD, et al. Intrinsic PEEP in patients with chronic obstructive

pulmonary disease: role of expiratory muscles. Am Rev Respir Dis, 1993, 148: 1037-1042.

7. Collaborative Research Group of Noninvasive Mechanical Ventilation for Chronic

Obstructive Pulmonary Disease. Early use of non-invasive positive pressure ventilation for acute exacerbations of chronic obstructive pulmonary disease: a multicentre randomized controlled trial. Chin Med J , 2005, 118(24):2034-40.

8. Elliott MW. Non-invasive ventilation for acute respiratory disease. British Medical Bulletin,

2004;,72: 83-9

9. 曹志新,王辰.无创机械通气的应用范围及指征.中华结核和呼吸杂志, 2002, 25 :136-137.

10. Nava S, Ambrosino N, Clini E, et al. Noninvasive mechanical ventilation in the weaning of

patients with respiratory failure due to chronic obstructive pulmonary disease: a randomized, controlled trial. Ann Intern Med, 1998,128(9):721–728.

11. Ferrer M, Esquinas A, Arancibia F, et al. Noninvasive ventilation during persistent weaning

failure:a randomized controlled trial. Am J Respir Crit Care Med, 2003,168(1):70–76.

12. 有创-无创序贯机械通气多中心协作组.以“肺部感染控制窗”为切换点行有创与无创序惯

性通气治疗慢性阻塞性肺疾病所致严重呼吸衰竭的多中心前瞻性随机对照研究.中华结核和呼吸杂志,2006,29(1):14-18.

13. 郑瑞强,刘玲,杨毅,等. 有创无创序贯机械通气治疗慢性阻塞性肺病所致急性呼吸衰竭的

研究. 中华急诊医学杂志,2005,14:21-25.

14. British Thoracic Society Standards of Care Committee. Non-invasive ventilation in acute

respiratory failure. Thorax, 2002, 57:192-211.

15. Keenan, SP, Sinuff T, Cook DJ, et al. Chronic Obstructive Pulmonary Disease Benefit from

Noninvasive Positive-Pressure Ventilation? A Systematic Review of the Literature. Ann Intern Med, 2003,138: 861-870.

16. Bott J, Carroll MP, Conway JH, et al. Randomized controlled trial of nasal ventilation in

acute respiratory failure due to chronic obstructive airway disease. Lancet, 1993,