无创双水平正压通气治疗硅沉着病合并肺动脉高压患者的效果观察  

Effect observation of noninvasive BiPAP therapy in pateins with silicosis and pulmonary hypertension

作　　者：向光明[1] 高宝安[1] 官莉[1] 

机构地区：[1]三峡大学第一临床医学院湖北省宜昌市中心人民医院呼吸内科,湖北宜昌443003

出　　处：《中国医药导报》2013年第35期59-61,共3页China Medical Herald

基　　金：湖北省自然科学基金项目(编号2012FFB06301)

摘　　要：目的 探讨无创双水平正压通气治疗硅沉着病合并肺动脉高压的临床效果.方法 选择2012年1月～2013年1月宜昌市中心人民医院收治的硅沉着病合并肺动脉高压患者50例,按照随机的原则将其分为观察组与对照组,每组各25例.对照组采取抗炎抗感染、镇咳祛痰、纠正电解质紊乱、维持酸碱平衡等常规治疗,观察组患者在此基础上给予无创双水平正压通气法进行治疗,采用BiPAP呼吸机连续治疗3个月.观察两组硅沉着病合并肺动脉高压患者临床疗效以及右心室射血分数（RVEF）、右心每搏输出量（RVSV）以及肺动脉压（PH）、心率（HR）变化情况.结果 采用BiPAP呼吸机连续治疗3个月后,观察组总有效率为88.0％ （22/25）,对照组总有效率为56.0％（14/25）,两组间差异有统计学意义（P＜0.05）.采用BiPAP呼吸机连续治疗3个月后,观察组RVEF[（58±6）％]、RVSV[（31.36±13.21）mL]高于治疗前[（42±4）％、（29.83±12.51）mL];PH[（36.8±5.1）mm Hg]、HR[（74±4）次/min]低于治疗前[（45.2±3.5）mmHg、（87±6）次/min],差异均有统计学意义（P＜0.05）.观察组治疗后RVEF、RVSV、PH、HR等指标均优于对照组,差异有统计学意义（P＜0.05）.结论 采用无创双水平正压通气法治疗硅沉着病合并肺动脉高压,可有效改善硅沉着病合并肺动脉高压患者的临床症状,降低PH,增加RVEF、RVSV,改善患者右心功能.值得在临床上推广应用.Objective To explore the effects of non-invasive Bi-level positive airway pressure treatment for silicosis with pulmonary hypertension.Methods 50 cases of silicosis with pulmonary hypertension in Yichang Central People＇s Hospital from January 2012 to January 2013 were selected and divided into observation group and control group with 25 cases in each group.The control group were treated with anti-inflammatory and anti-infection,antitussive and expectorant,correcting of electrolyte imbalance,maintaining acid-base balance and the other conventional therapy; the observation group was given conventional therapy and non-invasive method for Bi-level positive airway pressure therapy using BiPAP ventilation continuous treatment for 3 months.The clinical efficacy,right ventricular ejection fraction （RVEF）,right ventricular stroke volume （RVSV） and changes in pulmonary artery pressure （PH）,HR of patients with silicosis and pulmonary hypertension were observed before and after treatment.Results After treatment with BiPAP for 3 months,total effective rate of observation group was 88.0% （22/25）,total effective rate of control group was 56.0% （14/25）,the difference was statistically significant （P 〈0.05）.RVEF,RVSV of observation group after treatment with BiPAP for 3 months [（58±6） %,（31.36±13.21） mL] were higher than those before the treatment [（42±4） %,（29.83±12.51） mL]; PH,HR [（36.8±5.1） mm Hg,（74±4） times/min] were lower than those before the treatment [（45.2±3.5） mm Hg,（87±6） times/min],the differences were statistically significant （P 〈 0.05）.RVEF,RVSV,PH,HR of observation group after the treatment were all better than those of control group,the differences were statistically significant （P 〈 0.05）.Conclusion Noninvasive BiPAP treatment of silicosis with pulmonary hypertension can effectively improve clinical symptoms,reduce PH,increase RVEF,RVSV,improve right heart function,it is worthy of popularization and application.

关 键 词：硅沉着病 肺动脉高压 临床症状 无创双水平正压通气 治疗效果 

分 类 号：R563[医药卫生—呼吸系统]