无创辅助通气治疗慢性阻塞性肺疾病合并急性左心衰的疗效  

Curative effect of noninvasive assistant ventilation in the treatment of elderly patients with chronic obstructive pulmonary disease complicated with acute left heart failure

作　　者：沈斌[1] 戴莉莉[1] 陈晓红[1] 卢明[1] 秦斌斌[1] 金烨[1] 冯洁[1] 

机构地区：[1]上海市第二人民医院呼吸科,上海200011

出　　处：《临床肺科杂志》2013年第3期506-507,共2页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨临床应用双水平气道正压(BiPAP)通气治疗老年COPD合并急性左心衰的作用。方法将56例患有COPD合并急性左心衰的患者随机分为常规对照组(28例)和BiPAP治疗组(28例),观察分析动脉血气、呼吸频率、心率、血压、BNP。结果 BiPAP通气治疗可迅速的改善患者的症状,24 h后与常规治疗组相比,治疗组患者的心率减慢,呼吸频率减慢,收缩压下降,血气分析显示氧分压明显的提高(P<0.05).BiPAP治疗组血清BNP水平显著降低(P<0.05)。结论 BiPAP通气治疗老年COPD合并急性左心衰患者,可提高PaO2,降低PaCO2,改善心功能。Objective To evaluate the curative effect of bi-level positive airway pressure （BiPAP） ventilation in the treatment of elderly patients with chronic obstructive pulmonary disease complicated with acute left heart failure. Methods 56 COPD patients compli- cated with acute left heart failure were randomly and evenly divided into the conventional therapy group and the BiPAP group. The blood gas analysis, respiratory rates, heart rates, blood pressure and brain natriuretic peptide were monitored and analyzed. Results The symp- toms of the patients received BiPAP ventilation therapy could be improved rapidly. 24 hour after, the improvement of the heart rates, the respiratory rates, the systolic blood pressure and the level of serum BNP was more pronounced in the BiPAP group than in the conventional therapy group （P 〈 0. 05）. The partial pressure of oxygen increased more obviously in the BiPAP group than in the conventional therapy group （ P 〈 0.05）. Conclusion BiPAP ventilation can improve the level of PaO2 and heart function and lower the level of PaCO2 in the treatment of COPD patients complicated with acute left heart failure.

关 键 词：BIPAP无创通气 COPD 急性左心衰 

分 类 号：R563.9[医药卫生—呼吸系统]