夜间无创通气应用于稳定期慢性阻塞性肺疾病患者的临床观察  

The observation of nocturnal noninvasive positive pressure ventilation in patients with stable chronic obstructive pulmonary disease

作　　者：李元广[1] 徐效峰[1] 赵宇[1] 丘韶校[1] 

机构地区：[1]深圳市宝安区人民医院呼吸内科,518101

出　　处：《山西医药杂志》2015年第17期1993-1995,共3页Shanxi Medical Journal

摘　　要：目的研究夜间无创正压通气（NPPV）对Ⅲ~Ⅳ级稳定期慢性阻塞性肺疾病（COPD）患者的夜间血氧、动脉血气、生活质量的影响。方法将60例处于Ⅲ~Ⅳ级稳定期COPD患者按随机数字表法分为试验组和对照组。试验组采用夜间双水平气道正压通气（BiPAP）治疗加氧疗,对照组单纯夜间氧疗,治疗6个月。分析治疗前后2组夜间血氧、动脉血气、COPD评估测试问卷（CAT）分值的变化。结果治疗后与治疗前比较：试验组夜间平均血氧饱和度（MSaO2）、夜间最低血氧饱和度（MmSaO2）、动脉血氧分压（PaO2）、动脉血氧饱和度（SaO2）显著提高;对照组MSaO2、MmSaO2、PaO2、SaO2也明显升高;2组夜间血氧饱和度〉90%的时间占总睡眠时间的百分比（T90）显著降低;试验组动脉血二氧化碳分压（PaCO2）降低,而对照组PaCO2升高。试验组患者CAT评分显著下降,对照组无明显变化。治疗后试验组与对照组相比,MSaO2、MmSaO2、PaO2、SaO2显著升高,T90、PaCO2、CAT评分显著降低。结论夜间NPPV联合夜间氧疗能显著改善COPD患者夜间缺氧、动脉血气及生活质量,优于单纯夜间氧疗。Objective To observe the effect of nocturnal noninvasive positive pressure ventilation on noctur‐nal hypoxemia ,arterial blood gas ,chronic obstructive pulmonary disease（COPD） assessment test （CAT ） in pa‐tients with stage Ⅲ ‐Ⅳ stable COPD .Methods A total of 60 patients with stage Ⅲ ‐Ⅳ stable COPD were ran‐domly divided into the experiment group （ n=30）and the control group （ n=30） .The patients in the experiment group were given nocturnal noninvasive positive pressure ventilation in combination with nocturnal oxygen therapy （2 L/min）;while those in the control group were treated with nocturnal oxygen therapy （2 L/min） only .Noctur‐nal oxygen saturation （SaO2 ） ,arterial blood gases and CAT were examined before and after the treatment .Results After the treatment ,nocturnal mean SaO2 （MSaO2 ） ,nocturnal minimum SaO2 （MmSaO2 ） ,arterial partial pres‐sure of oxygen （PaO2 ） ,arterial SaO2 and CAT were significantly improved in the experiment group .In the con‐trol group ,MSaO2 ,MmSaO2 ,PaO2 and SaO2 were significantly increased too ,but no change in CAT was ob‐served .Both groups showed significant decreases in the percentage of the time with nocturnal SaO2 〈90% in the total sleep time （T90） .Arterial partial pressure of carbon dioxide （PaCO2 ）was significantly decreased in the ex‐periment group;however it was increased in the control group .After the treatment ,compared with control group ,the MSaO2 ,MmSaO2 ,PaO2 and SaO2 in the experiment group were improved obviously ;the PaCO2 ,T90 and CAT in the experiment group were decreased significantly .Conclusion Nocturnal noninvasive positive pres‐sure ventilation in combination with nocturnal oxygen therapy could significantly improve nocturnal hypoxemia , arterial blood gases and CAT in patients with stable COPD ,which is superior to nocturnal oxygen therapy alone .

关 键 词：肺疾病 慢性阻塞性 夜间无创通气 

分 类 号：R563.9[医药卫生—呼吸系统]