叶为胜
赣南医科大学
摘要(Abstract):
慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease,COPD)简称慢阻肺,是由于气流受限导致呼吸困难的一种常见慢性呼吸系统疾病,其进展至中晚期常合并呼吸衰竭,尤其是Ⅱ型呼吸衰竭,临床管理难度大。近年来,COPD合并呼吸衰竭的诊疗策略已从单一对症支持转向多维度联合干预,涵盖无创通气优化、药物协同、护理创新及康复治疗等多个方面。本文基于2021 年至2025年国内外研究进展,系统梳理了COPD合并呼吸衰竭的发生机制、危险因素与预测模型,重点总结了以无创通气为核心的综合治疗策略及其联合中药、阿片受体拮抗剂、免疫调节剂等的临床应用效果。同时,介绍了危机理论与感知理论指导下的护理干预、精准肺康复等综合管理措施的最新进展,并指出当前领域在预测模型验证、中药机制研究、个体化诊疗等方面仍存在不足。未来应加强多中心合作,推动精准医疗与中西医结合研究,优化呼吸支持技术,以进一步提升临床疗效与患者生活质量。
关键词(KeyWords):
慢性阻塞性肺疾病;呼吸衰竭;无创通气;综合护理
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