无创通气对无呼吸衰竭COPD患者呼吸肌疲劳的影响  

Effects of noninvasive positive pressure ventilation on respiratory muscle fatigue in the patients with chronic obstructive pulmonary disease without respiratory failure

作　　者：谭焰[1] 孙丽华[1] 乔岩[1] 方苏榕[1] 王丽[1] 

机构地区：[1]南京医科大学附属南京第一医院呼吸科,江苏南京210006

出　　处：《南京医科大学学报（自然科学版）》2006年第8期686-689,共4页Journal of Nanjing Medical University(Natural Sciences)

基　　金：南京市科技发展计划(编号200301091-4)

摘　　要：目的:观察无创通气(NIPPV)对无呼吸衰竭的轻中度慢性阻塞性肺疾病(COPD)急性加重期患者呼吸肌疲劳的影响。方法:44例COPD患者随机分为NIPPV组和对照组,观察治疗前后两组临床表现、动脉血气、肺功能、辅助呼吸肌动用评分、呼吸困难评分和预后的变化。结果:NIPPV组在通气2h后显著改善动脉血气,降低心率和呼吸频率,减少辅助呼吸肌参与(P<0.05),且在24h后仍与对照组有显著差异。NIPPV组的肺功能在治疗后显著改善,住院时间也明显缩短。结论:轻中度COPD急性加重期患者虽无呼吸衰竭、但已存在呼吸肌疲劳,早期应用NIPPV能迅速缓解呼吸肌疲劳,改善气体交换,缩短住院时间,降低呼吸衰竭的发生率。Objective： To investigate the effects of noninvasive positive pressure ventilation （NIPPV） on respiratory muscle fatigue in patients with milder chronic obstructive pulmonary disease （COPD） without respiratory failure. Methods： Forty-four patients were randomized to NIPPV group and control group. The clinical manifestations, arterial blood gases, pulmonary functions, dyspnea score, scale for accessory muscle use and outcome were analyzed. Results： Arterial blood gases, respiratory rate, heart rate and scale for accessory muscle use were improved rapidly at the first 2 h in patients of NIPPV group（P 〈 0.05）. The differences between the two groups were kept to 24-h treatment. The pulmonary functions were improved after ventilation,and the duration of hospital was decreased by NIPPV. Conclusion： Although respiratory failure does not occur in patients with milder COPD exacerbations,respira tory muscle fatigue already exists. NIPPV causes a more rapid improvement in respiratory muscle fatigue, gas exchange and decreases the duration of hospital to avoid respiratory failure.

关 键 词：无创通气 慢性阻塞性肺疾病 呼吸肌疲劳 

分 类 号：R563.8[医药卫生—呼吸系统]