肺源性心脏病患者的无创正压通气治疗  

Effects of BiPAP ventilation on hemodynamics during acute right ventricular failure of chronic obstructive pulmonary disease

作　　者：曹玉书[1] 曾葭[1] 童皖宁[1] 于锐[2] 李奕[1] 闫丽娟[1] 

机构地区：[1]解放军411医院呼吸科,上海200081 [2]解放军411医院超声科,上海200081

出　　处：《中国呼吸与危重监护杂志》2005年第1期50-52,共3页Chinese Journal of Respiratory and Critical Care Medicine

摘　　要：目的观察慢性阻塞性肺疾病(COPD)心、肺功能失代偿期患者无创正压通气中心肺血流动力学的变化。方法应用彩色多谱勒超声心动图方法,测定17例右心功能失代偿期COPD患者应用BiPAP呼吸机辅助通气前、后心肺功能有关参数的变化。结果17例患者在BiPAP呼吸机治疗期间,心率和呼吸频率减慢,潮气量和每分通气量增加;收缩压和舒张压保持稳定,右室舒张末期内径、肺动脉压和心输出量均无明显变化(P>005)。结论BiPAP呼吸机用于COPD心肺功能失代偿的患者,对心、肺血流动力学未见显著影响。Objective The aim of this study was to investigate the hemodynamic effects of bilevel positive airway pressure (BiPAP) ventilation on respiratory and circulatory system in patients with chronic obstructive pulmonary disease (COPD) and right ventricular failure.Methods Seventeen patients suffering from COPD with right ventricular failure were included.All of them were treated by BiPAP ventilator with inspiratory pressure of (15.1±3.8)cm H_2O and expiratory pressure of (3.7±0.5)cm H_2O via facial mask.The pulmonary artery pressure,cardiac output and right ventricular diameter were determined by Doppler echocardiography.Results Changes in the respiratory and hemodynamic parameters were analysed using a paired t test.With reference to baseline values,tidal volume increased and respiratory rate decreased significantly during BiPAP administration in all patients;There were no significant differences in any of the hemodynamic parameters measured in the experiment.Conclusion This study provides further evidence that the BiPAP does not alter hemodynamics acutely in COPD patients with right ventricular failure.

关 键 词：患者 BIPAP呼吸机 无创正压通气治疗 失代偿期 肺源性心脏病 COPD 心肺功能 肺血流动力学 彩色多谱勒超声 辅助通气 

分 类 号：R541.5[医药卫生—心血管疾病]