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<\/h2>\n

\u3010\u6cbb\u7597\u3011<\/p>\n

\u4e00\u3001\u7a33\u5b9a\u671f\u6cbb\u7597<\/p>\n

1\uff0e\u6559\u80b2\u548c\u529d\u5bfc\u60a3\u8005\u6212\u70df\uff1b\u56e0\u804c\u4e1a\u6216\u73af\u5883\u7c89\u5c18\u3001\u523a\u6fc0\u6027\u6c14\u4f53\u6240\u81f4\u8005\uff0c\u5e94\u8131\u79bb\u6c61\u67d3\u73af\u5883\u3002<\/p>\n

2\uff0e\u652f\u6c14\u7ba1\u8212\u5f20\u836f\u5305\u62ec\u77ed\u671f\u6309\u9700\u5e94\u7528\u4ee5\u6682\u65f6\u7f13\u89e3\u75c7\u72b6\uff0c\u53ca\u957f\u671f\u89c4\u5219\u5e94\u7528\u4ee5\u9884\u9632\u548c\u51cf\u8f7b\u75c7\u72b6\u4e24\u7c7b\u3002<\/p>\n

(1) \u03b22\u80be\u4e0a\u817a\u7d20\u53d7\u4f53\u6fc0\u52a8\u5242\uff1a\u4e3b\u8981\u6709\u6c99\u4e01\u80fa\u9187(salbutamol)\u6c14\u96fe\u5242\uff0c\u6bcf\u6b21100\uff5e200\u03bcg(1\uff5e2\u55b7)\u3002\u96fe\u5316\u5438\u4eba\uff0c\u7597\u6548\u6301\u7eed4\uff5e5\u5c0f\u65f6\uff0c\u6bcf24\u5c0f\u65f6\u4e0d\u8d85\u8fc78\uff5e12\u55b7\u3002\u7279\u5e03\u4ed6\u6797(terbutaline)\u6c14\u96fe\u5242\u4ea6\u6709\u540c\u6837\u4f5c\u7528\u3002<\/p>\n

(2)\u6297\u80c6\u78b1\u836f\uff1a\u662fCOPD\u5e38\u7528\u7684\u5236\u5242\uff0c\u4e3b\u8981\u54c1\u79cd\u4e3a\u5f02\u4e19\u6258\u6eb4\u94f5(ipratropium)\u6c14\u96fe\u5242\uff0c\u96fe\u5316\u5438\u5165\uff0c\u8d77\u6548\u8f83\u6c99\u4e01\u80fa\u9187\u6162\uff0c\u6301\u7eed6\uff5e8\u5c0f\u65f6\u3002\u6bcf\u6b2140\uff5e80\u03bcg(\u6bcf\u55b720\u03bcg)\uff0c\u6bcf\u59293\uff5e4\u6b21\u3002<\/p>\n

(3)\u8336\u78b1\u7c7b\uff1a\u8336\u78b1\u7f13\u91ca\u6216\u63a7\u91ca\u7247\uff0c0\uff0e2g\uff0c\u65e9\u3001\u665a\u5404\u4e00\u6b21\uff1b\u6c28\u8336\u78b1(aminophylline)\uff0c0\uff0e1g\uff0c\u6bcf\u65e53\u6b21\u3002<\/p>\n

\u9664\u4ee5\u4e0a\u652f\u6c14\u7ba1\u8212\u5f20\u5242\u5916\uff0c\u5c1a\u6709\u6c99\u7f8e\u7279\u7f57(salmeterol)\u3001\u798f\u83ab\u7279\u7f57(formoterol)\u7b49\u957f\u65488\uff1a\u80be\u4e0a\u817a\u7d20\u53d7\u4f53\u6fc0\u52a8\u5242\uff0c\u5fc5\u8981\u65f6\u53ef\u9009\u7528\u3002<\/p>\n

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4\uff0e\u957f\u671f\u5bb6\u5ead\u6c27\u7597(LTOT) \u5bf9COPD\u6162\u6027\u547c\u5438\u8870\u7aed\u8005\u53ef\u63d0\u9ad8\u751f\u6d3b\u8d28\u91cf\u548c\u751f\u5b58\u7387\u3002\u5bf9\u8840\u6d41\u52a8\u529b\u5b66\u3001\u8fd0\u52a8\u80fd\u529b\u3001\u80ba\u751f\u7406\u548c\u7cbe\u795e\u72b6\u6001\u5747\u4f1a\u4ea7\u751f\u6709\u76ca\u7684\u5f71\u54cd\u3002LTOT\u6307\u5f81\uff1a\u2460PaO2\u226455mmHg\u6216SaO2\u226488\uff05\uff0c\u6709\u6216\u6ca1\u6709\u9ad8\u78b3\u9178\u8840\u75c7\u3002\u2461PaO255\uff5e60mmHg\uff0c\u6216SaO2<89\uff05\uff0c\u5e76\u6709\u80ba\u52a8\u8109\u9ad8\u538b\u3001\u5fc3\u529b\u8870\u7aed\u6c34\u80bf\u6216\u7ea2\u7ec6\u80de\u589e\u591a\u75c7(\u8840\u7ec6\u80de\u6bd4\u5bb9>0\uff0e55)\u3002\u4e00\u822c\u7528\u9f3b\u5bfc\u7ba1\u5438\u6c27\uff0c\u6c27\u6d41\u91cf\u4e3a1\uff0e0\uff5e2\uff0e0L\uff0fmin\uff0c\u5438\u6c27\u65f6\u95f4>15h\uff0fd\u3002\u76ee\u7684\u662f\u4f7f\u60a3\u8005\u5728\u6d77\u5e73\u9762\uff0c\u9759\u606f\u72b6\u6001\u4e0b\uff0c\u8fbe\u5230PaO2\u226560mmHg\u548c(\u6216)\u4f7fSaO2\u5347\u81f390%\u3002<\/p>\n

\u4e8c\u3001\u6025\u6027\u52a0\u91cd\u671f\u6cbb\u7597<\/p>\n

1\uff0e\u786e\u5b9a\u6025\u6027\u52a0\u91cd\u671f\u7684\u539f\u56e0\u53ca\u75c5\u60c5\u4e25\u91cd\u7a0b\u5ea6\u3002\u6700\u591a\u89c1\u7684\u6025\u6027\u52a0\u91cd\u539f\u56e0\u662f\u7ec6\u83cc\u6216\u75c5\u6bd2\u611f\u67d3\u3002<\/p>\n

2\uff0e\u6839\u636e\u75c5\u60c5\u4e25\u91cd\u7a0b\u5ea6\u51b3\u5b9a\u95e8\u8bca\u6216\u4f4f\u9662\u6cbb\u7597\u3002<\/p>\n

3\uff0e\u652f\u6c14\u7ba1\u8212\u5f20\u836f\uff1a\u836f\u7269\u540c\u7a33\u5b9a\u671f\u3002<\/p>\n

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4\uff0e\u63a7\u5236\u6027\u5438\u6c27\uff1a\u53d1\u751f\u4f4e\u6c27\u8840\u75c7\u8005\u53ef\u9f3b\u5bfc\u7ba1\u5438\u6c27\uff0c\u6216\u901a\u8fc7\u6587\u4e18\u91cc(Venturi)\u9762\u7f69\u5438\u6c27\u3002\u9f3b\u5bfc\u7ba1\u7ed9\u6c27\u65f6\uff0c\u5438\u4eba\u7684\u6c27\u6d53\u5ea6\u4e0e\u7ed9\u6c27\u6d41\u91cf\u6709\u5173\uff0c\u4f30\u7b97\u516c\u5f0f\u4e3a\u5438\u5165\u6c27\u6d53\u5ea6(\uff05)== 2l+4\u00d7\u6c27\u6d41\u91cf(L\uff0fmin)\u3002\u4e00\u822c\u5438\u4eba\u6c27\u6d53\u5ea6\u4e3a28 9\uff0f6\uff5e30\uff05\uff0c\u5e94\u907f\u514d\u5438\u5165\u6c27\u6d53\u5ea6\u8fc7\u9ad8\u5f15\u8d77\u4e8c\u6c27\u5316\u78b3\u6f74\u7559\u3002<\/p>\n

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