Objective To investigate the effectiveness of noninvasive positive pressure ventilation( NPPV) in acute exacerbation of chronic obstructive pulmonary disease ( AECOPD) complicated with severe type Ⅱ respiratory failure.Methods 37 patients who were admitted fromJanuary 2008 to June 2009 due to AECOPD complicated with severe type Ⅱ respiratory failure and had received NPPV therapy were enrolled as a NPPV group. Another similar 42 cases who had not received NPPV therapy served as control. All subjects received standard medication therapy according to the guideline. Arterial blood gases before and after treatment, the duration of hospitalization and intubation rate were observed. Results The arterial pH, PaO2 ,and PaCO2 improved significantly after treatment as compared with baseline in both groups ( P lt; 0. 05) .Compared with the control group, the average duration of hospitalization was significantly shorter ( 10 ±5 vs.19 ±4 days, P lt;0. 05) and the intubation rate was significantly lower ( 2. 7% vs. 16. 7% , P lt;0. 05) in the NPPV group. Conclusion The use of NPPV in AECOPD patients complicated with severe type Ⅱ respiratory failure is effective in improving arterial blood gases, reducing the duration of hospitalization and intubation rate.
目的 评价选择性介入治疗在原发性肝癌（HCC）门脉高压症中的应用价值。 方法 2008年11月－2011年3月，收治65例临床明确诊断的HCC伴门脉高压症患者，选择性使用肝动脉化学疗法（化疗）栓塞术、脾栓塞术、门静脉化疗栓塞术、门静脉支架、胃冠状静脉栓塞术等介入术式，术后通过观察临床指标、定期复查影像检查等了解病变转归，随访生存期并评价疗效。 结果 65例HCC患者均合并不同程度门静脉高压，其中门静脉癌栓46例中有37例显示肝动脉-门静脉分流，通过肝动脉及门静脉化疗栓塞术进行主瘤体及癌栓治疗。11例行门静脉支架置入术，支架置入后门静脉压较术前明显下降（P＜0.01），支架中位通畅时间为5.8个月。39例行胃冠状静脉和（或）胃短静脉栓塞术，术后有4例再次发生门脉高压性出血，再出血率10.26%。18例行脾动脉栓塞术，术后3个月血小板较术前显著升高（P＜0.01）。随访术后3、6、12及24个月的生存率分别为90.77%、69.23%、35.38%及13.85%。 结论 选择性联合使用各种介入术式是治疗HCC及其相关性门脉高压症的一种有效方法，可有效预防高危风险，延长患者生存期。