15 1 12 1 2 2 2 2.1.............................. 3 2.2........................... 3 2.3 β........................ 6 2.4............................ 7 3 8 3.1....................... 8 3.2.................... 8 3.3....................... 10 4 11 5 ICU 12 6 12 6.1..................... 13 6.2........................... 14 7 14 7.1............................ 14 7.2......................... 15 7.3......................... 15 8 16 8.1......................... 16 8.2........................... 16 8.3.......................... 16 1
1 FEV1.0 FEV1.0 30 80% NIH FEV1.0 50 80% FEV1.0 50% FEV1.0 cyanosis PaO2 PaCO2 PaO2 PaCO2 40mmHg FEV1.0 25% 2 1 1 2
2.1 CO2 CO2 SpO290 95 CO2 1: COPD COPD CO2 CO2 SpO290 95 2.2 MDI MDI 3
2: MDI 3: 2 ( ) 4
4: MDI MDI 6 12 2 0.5 1ml+ 5ml 20 0.5 1ml+ 5ml 20 2 3ml+ 10ml 1 2 4 3 20 2 3 5
5: (C) (A) levalbuterol β albuterol R (levalbuterol) β R S R levalbuterol albuterol 2.3 β terbutaline 0.3ml 20 β β 6
2.4 40 24 FEV1.0 3 review 10 15mg/kg/24h 1 120 180mg 60 125mg 1 4 ER 40mg1 1 3 7
3 3.1 6: 3.2 T 8
7: 8: ( ) 750ml 9
9 9: 8 ( ) T T 3.3 salbutamol( ) 5 7.5mg 10mg 7.5mg 2.5 5mg 20 30 4 7.5 10mg 1 2 2ml(5mg/ml) 10ml 6 12ml/h 4 10
10: ( ) ( ) 4 β 1 3 FEV1.0 70% 1 FEV1.0 70 50% 11
1 4 FEV1.0 50% 5 ICU 4 ICU FEV1.0 25% PaO2 40% 65mmHg PaCO2 40mmHg FEV1.0 6 FEV1.0 50% 7 10 12
COPD COPD CPAP PEEP BiPAP Mk7 IPPB 17 5 17 2 6.1 90 6 5 COPD 6 13
6.2 17 PEEP 0 PS 10cmH2O PEEP 3 5cmH2O 1 7ml/kg 25 / PS 4 15 7 7.1 (PaCO240mmHg ) PaO250mmHg H PaCO2 14
7 7.2 7.3 1 2mg/kg 10 15 2 2.5mg/kg 8 1 7 8 15
1mg/kg Rocuronium 9 8 8.1 1.2g 20 8.2 200mg 400mg ( ) 8.3 9 ( )? 16