在3992m海拔高度吸氧及局部增压对高原缺氧疗效的对比研究  

Comparative Study of Oxygen and Pressure Support Therapy on Plateau Hypoxia at an Altitude of 3992 Meters

作　　者：孙亮[1,2] 车杰[3] 张健鹏[1] 李胜僇 刘建华[1] 樊毫军[1] 柯颖 马绎贤 刘玉良 

机构地区：[1]武警总医院呼吸科,北京100039 [2]武警医学院附属医院呼吸科 [3]武警青海总队卫生处,青海西宁810000 [4]武警青海总队三支队卫生队,青海格尔木816000

出　　处：《中国呼吸与危重监护杂志》2009年第4期392-395,共4页Chinese Journal of Respiratory and Critical Care Medicine

摘　　要：目的评价吸氧和局部增压对高原缺氧的治疗效果。方法在3992m海拔高度选取健康男性45名(非高原世居,高原居住时间1～2年),随机分为吸氧组、单兵增氧呼吸器组、无创通气组三组。吸氧组采用常规经鼻吸氧,流量2L/min;单兵增氧呼吸器组采用单兵高原增氧呼吸器辅助呼吸;无创通气组采用双水平无创正压通气(BiPAP)辅助呼吸,吸气压力(IPAP)10cmH2O、呼气压力(EPAP)4cmH2O;干预时间均为30min,单兵增氧呼吸器组和无创通气组在受试前30min及受试期间均不吸氧。分别测定各组静息状态下和干预30min时的PaO2、PaCO2、SpO2及心率(HR)等指标。结果吸氧组PaO2从治疗前的(54.43±3.01)mmHg增高到治疗后的(91.36±10.99)mmHg(P<0.01),PaCO2从(30.41±1.51)mmHg提高到(32.56±2.98)mmHg(P<0.05);无创通气组PaO2从治疗前的(53.30±4.88)mmHg增高到治疗后的(58.58±5.05)mmHg(P<0.01),PaCO2从(28.74±2.91)mmHg降低到(25.82±4.35)mmHg(P<0.05);单兵增氧呼吸器组PaO2从治疗前的(56.00±5.75)mmHg降低到治疗后的(50.82±5.40)mmHg(P<0.05),PaCO2无显著变化[(28.65±2.78)mmHg到(29.75±3.89)mmHg,P>0.05]。结论在3992m海拔高度,吸氧及BiPAP均能显著提高受试者的PaO2及SpO2,单兵增氧呼吸器对PaO2及SpO2无明显改善作用。Objective To compare the effects of oxygen therapy and local pressurization in alleviating plateau hypoxia at high altitude. Methods Forty-five healthy male soldiers were investigated at an altitude of 3992 meters. The subjects were randomly divided into three groups, /e. an oxygen inhalation group, a single-soldier oxygen increasing respirator （SOIR） group and a BiPAP group. The oxygen inhalation group was treated with oxygen inhalation via nasal catheter at 2 L/min. SOIR was used to assist breath in the SOIR group. The BiPAP group were treated with hi-level positive airway pressure ventilation, with IPAP of 10 cm H2O and EPAP of 4 em H20. PaO2, PaCO2, SpO2 and heart rate were measured before and 30 minutes after the treatment. Results There were continuous increase of PaO2 from （ 53.30 ± 4. 88 ） mm Hg to （58. 58±5.05） mm Hg and （54. 43 ±3.01 ） mm Hg to （91.36 ±10. 99） mm Hg after BiPAP ventilation and oxygen inhalation, respectively （ both P 〈 0. 01 ）. However, the PaO2 of the SOIR group was decreased from （56. 00 ±5.75 ） mm Hg to （ 50. 82± 5.40 ） mm Hg （ P 〈 0. 05 ）. In the other hand, the PaCO2 was increased from （30. 41± 1.51 ） mm Hg to （32.56 ±2. 98） mm Hg in the oxygen inhalation group （P 〈 0. 05 ）, declined from （ 28.74 ± 2. 91 ） mm Hg to （ 25.82 ± 4. 35 ） mm Hg in the BiPAP group （ P 〈 0. 05 ）, and didn＇ t change significantly from （28.65 ±2. 78 ） mm Hg to （29. 75 ± 3.89） mm Hg in the SOIR group （P 〉 0.05）. Conclusions Both BiPAP ventilation and oxygen inhalation can alleviate plateau hypoxia by improving PaO2 at 3992 meter altitude while SOIR has no significant effect.

关 键 词：高原缺氧 吸氧 无创通气 双水平气道正压 单兵增氧呼吸器 血气分析 

分 类 号：R594.3[医药卫生—内科学] R644[医药卫生—临床医学]