无创正压通气对COPD合并肺源性心脏病急性加重期患者疗效和血气、炎性指标的影响  

Efficacy of noninvasive positive pressure ventilation on patients with chronic obstructive pulmonary disease complicated with pulmonary heart disease in acute exacerbation period and the effect on blood gas and inflammatory index

作　　者：雷应军 胡振红[1] 刘海潮[1] 

机构地区：[1]广州军区武汉总医院呼吸内科,430000

出　　处：《疑难病杂志》2016年第3期233-235,240,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的观察无创正压通气对慢性阻塞性肺疾病(COPD)合并肺源性心脏病急性加重期患者的临床疗效及血气、炎性指标的影响。方法选取2013年3月—2015年3月广州军区武汉总医院呼吸内科进行治疗的慢性阻塞性肺疾病合并肺源性心脏病急性加重期患者80例,随机数字表法分成观察组和对照组各40例。对照组采用慢性阻塞性肺疾病合并肺源性心脏病的常规治疗方法进行治疗;观察组在对照组常规治疗的基础上进行无创正压通气。治疗后观察2组的治疗效果,并检测记录所有患者治疗前后的血气指标[动脉二氧化碳分压(PaCO_2)、动脉氧分压(PaO_2)、血氧饱和度(SaO_2)、pH值]及炎性因子(CRP和BNP)水平的变化。结果治疗后,观察组总有效率为95.0%,明显高于照组的77.5%(x^2=5.165,P<0.05);与治疗前比较,2组治疗后血气指标、CRP及BNP水平均有改善,且观察组改善优于对照组(P均<0.05)。结论无创正压通气治疗慢性阻塞性肺疾病合并肺源性心脏病急性加重期患者具有较好的临床效果,能够有效改善患者的血气指标,值得推广使用。Objective To observe the effect of noninvasive positive pressure ventilation on patients with chronic obstructive pulmonary disease（COPD） complicated with pulmonary heart disease in acute exacerbation period and the effect on blood gas and inflammatory index.Methods Selected 80 cases of COPD combined with pulmonary heart disease acute exacerbation patients from 2013 March to 2015 March treated at Guangzhou Military Region,Wuhan General Hospital,according to the random number table method,these patients were divided into observation group and control group with 40 eases in each group.The control group was treated with routine treatment For COPD combined with pulmonar） heart disease,and the observation group was treated with noninvasive positive pressure ventilation on the basis of conventional treatment.After treatment,the therapeutic effect of the two groups were compared,delected and recorded all patients＇ before and after treatment blood gas index[arterial carbon dioxide partial pressure value（PaCO2）,the arterial oxygen partial pressure（PaO2）,oxygen saturation（SaO2 pH）]and inflammatorj factor（CRP and BNP） level changes.Results Alter treatment,the observation group＇s total efficiency was 95.0%,which was higher than control group＇s 77.5%（x^2=5.165,P〈0.05）;compared with before treatment,blood gas index,CRP and BNP levels were improvement after treatment,and the observation group better than the control group（P〈0.05）.Conclusion Non invasive positive pressure ventilation in the treatment of chronic obstructive pulmonary disease（villi acute exacerbation oi pulmonary heart disease patients showed good clinical effect,it can effectively improve the patient＇s blood gas indicators,it is worth promoting the application.

关 键 词：无创正压通气 慢性阻塞性肺疾病 肺源性心脏病急性加重期 血气分析 炎性因子 

分 类 号：R563.9[医药卫生—呼吸系统] R541.5[医药卫生—内科学]