慢性阻塞性肺疾病并呼吸衰竭患者经持续气道内正压通气治疗后反流性咳嗽两种诊断方法的探讨  

Exploration of two diagnosis methods in reflux cough after continuous positive airway pressure ventilation in the patients with chronic obstructive pulmonary disease and respiratory failure

作　　者：梁少红[1] 冯曙平[1] 陈艳[1] 冼慧仪[1] 谭锦志[1] 田峰 

机构地区：[1]广州医学院荔湾医院呼吸科,510170 [2]消化内科

出　　处：《中国医师进修杂志》2011年第31期4-6,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨慢性阻塞性肺疾病（COPD）并呼吸衰竭患者经持续气道内正压（cPAP）通气治疗后反流性咳嗽24h食管pH值监测及质子泵抑制剂（PPI）试验性治疗两种诊断方法的临床价值。方法选择COPD并呼吸衰竭经CPAP通气治疗后出现反流性咳嗽患者27例，采用随机数字表法分为两组，24h食管pH值监测组11例，PPI试验性治疗组16例。结果24h食管pH值监测组诊断反流性咳嗽9例，阳性率81．82％（9／11）；PPI试验性治疗组诊断反流性咳嗽14例，阳性率87．50％（14／16）。两组阳性率比较差异无统计学意义（P〉0．05）。结论COPD并呼吸衰竭患者经CPAP通气治疗后出现反流性咳嗽，行PPI试验性治疗的诊断准确率高，抗反流治疗疗效好，方法简单，易操作，较好地适用于COPD并呼吸衰竭危重患者，比24h食管pH值监测更有临床应用价值，适宜在基层医院推广。Objective To discuss the practical value of two diagnosis methods by 24 hours esophageal pH monitoring and proton pump inhibitor （PPI） treatment trial in reflux cough after continuous positive airway pressure （CPAP） ventilation in patients with chronic obstructive pulmonary disease （COPD） and respiratory failure. Methods Twenty-seven patients with COPD and respiratory failure and had reflux cough after CPAP ventilation were divided into 2 groups by random digits table,24 hours esophageal pH monitoring group （ 11 cases） and PPI treatment trial group （ 16 cases）. Results Nine cases were diagnosed reflux cough in 24 hours esophageal pH monitoring group, positive rate was 81.82% （9/11 ）; 14 cases were diagnosed reflux cough in PPI treatment trial group, positive rate was 87.50% （14/16）. There was no statistical difference between two groups （P 〉 0.05）. Conclusions The diagnosis accuracy rate is very hizhby PPI treatment trial in diagnosing reflux cough after CPAP in the patients with COPD and respiratory failure ventilation. This method is simple, easy to operate and it can be extended in primary hospitals.

关 键 词：肺疾病 慢性阻塞性 呼吸功能不全 连续气道正压通气 胃食管反流 质子泵抑制剂 

分 类 号：R563[医药卫生—呼吸系统]