无创正压通气治疗COPD合并Ⅱ型呼吸衰竭伴右心衰竭临床分析(1)
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【摘要】 目的 探讨无创正压通气(NPPV)对慢性阻塞性肺病(COPD)合并Ⅱ型呼吸衰竭伴右心衰竭的治疗作用。 方法 选择COPD合并Ⅱ型呼吸衰竭伴右心衰竭57例，随机分为常规治疗组(27例)与常规治疗辅助NIPPV治疗组(30例)，观察患者的心率、呼吸频率、血气分析指标及血浆NTProBNP水平。结果 治疗后两组心率、呼吸频率呈下降趋势、血气分析指标呈好转趋势，NTProBNP水平呈下降趋势。结论 NIPPV可改善COPD合并Ⅱ型呼吸衰竭伴右心衰竭患者的酸中毒、增加氧合指数、减少PaCO2；NTProBNP在呼衰并右心衰竭患者的诊断及疗效评价尚待进一步研究。
【关键词】
COPD；Ⅱ型呼吸衰竭；右心衰竭；NIPPV
Effect of noninvasive positive pressure ventilation in the treatment of patients with COPD and pulmonary heart disease and type Ⅱ respiratory failure
TUErXun Guli Burhan,DU Xianglin,LIU Zhanhong,et al.
Department of Pneumology,Friendship Hospital of Urumqi City,Urumqi 830049,China
【Abstract】 Objective
To detect the effect of noninvasive positive pressure ventilation (NIPPV) in the treatment of patients with COPD and pulmonary heart disease and type Ⅱ respiratory failure.Methods Fiftyseven patients with COPD and pulmonary heart disease and type Ⅱ respiratory failure were enrolled in the study. The patients were divided randomly into routine therapy group (n= 27) and the NIPPV group (n= 30). The patients in routine therapy group were treated with routine therapy only and those in experiment group were treated with both routine therapy and NIPPV by Bilevel positive airway pressure (BiPAP) mode. In each group, parameters of gas exchange, heart rate and respiratory rate and NTProBNP were measured.Results The effect of the NIPPV group was slight better than that of routine therapy group. The heart rate and respiratory rate were up and gas exchange were showed on good track in the NIPPV group. Conclusion NIPPV can improve several physiological parameters of patients with COPD and pulmonary heart disease and typeⅡrespiratory failure in reducing acid poisoning,increasing hematopneic index and reducing PaCO2. It need to explore if NTProBNP can be use of disease diagnosis and cure effect evaluation in the people of COPD and pulmonary heart disease and type Ⅱ respiratory failure.
【Key words】
COPD; TypeⅡrespiratory failure; Pulmonary heart disease；NIPPV
作者单位：830049新疆乌鲁木齐市友谊医院呼吸科 ......
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