AECOPD患者NPPV不同压力支持水平对腹内压力的影响  

Effect of NPPV with Different Pressure Support Level on the Intra-abdominal Pressure in Patients with AECOPD

作　　者：柳骥戎[1] 蒋丽 胡力 黄江华 李云龙[3] 

机构地区：[1]自贡市第五人民医院老年科,四川自贡643020 [2]四川医科大学附属第一医院老年科,四川泸州643000 [3]泸州医学院附属医院老年科,四川泸州643000

出　　处：《现代生物医学进展》2016年第15期2965-2968,共4页Progress in Modern Biomedicine

基　　金：四川省卫生厅科研课题(100067)

摘　　要：目的:探讨慢性阻塞性肺病急性加重期(AECOPD)患者无创正压通气(NPPV)不同压力支持水平对腹内压力的影响。方法:收集我院收治的AECOPD患者150例,随机分为A、B、C三组,每组各50例。给予所有患者无创机械通气,A、B、C组患者分别给予吸气相正压(IPAP)值为12 cm H2O、16 cm H2O、20 cm H2O,其他参数一致,通气治疗结束后,对所有患者的腹内压、不良反应发生率、呼吸困难程度以及动脉血气水平进行检测并比较。结果:通气后,A、B、C三组患者腹内压水平与通气前相比升高(P<0.05);与A、B组患者相比,C组患者腹内压水平较高(P<0.05);通气后,A、C两组患者的不良反应发生率与B组相比较高(P<0.05);通气后,B组患者呼吸困难评分与A、C组相比较高(P<0.05)。治疗后,三组患者的Pa O2与通气前相比升高,Pa CO2降低(P<0.05),与A、C组相比,B组患者的Pa O2水平较高,Pa CO2较低(P<0.05)。结论:AECOPD患者通气后腹内压水平随NPPV压力的升高而升高;中等压力的无创正压通气能够改善AECOPD患者的呼吸困难以及动脉血气水平,降低不良反应发生率。Objective： To investigate the effect of noninvasive positive pressure ventilation（NPPV）in patients with different pressure support level on the intra-abdominal pressure in patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）.Methods： 150 cases of AECOPD patients in our hospital were selected and randomly divided into group A, group B and group C, 50 cases in each group. All the patients were given no invasive mechanical ventilation, and the patient in A, B, C groups were given inspiration positive airway pressure（IPAP） value for 12 cm H2 O, 16 cm H2 O, 20 cm H2 O, respectively, and the other parameters were the same. After the end of the ventilation in the treatment, with the intra-abdominal pressure, incidence of adverse reactions, degree of dyspnea, and the level of arterial blood gas were detected and compared among three groups. Results： Compared with before treatment, the intra-abdominal pressure level were higher（P〈0.05）, and compared with the group A and the group B, the intra-abdominal pressure level in group C were higher（P〈0.05）; Compared with the group B, the incidence of adverse reactions were higher and the dyspnea score was lower in group A and group C（P〈0.05）; Compared with before treatment, the Pa O2 level was higher（P〈 0.05）, the Pa CO2 level was lower（P〈 0.05）. Compared with A and C group, the Pa O2 level of B group was higher and Pa CO2 was lower（P〈0.05）. Conclusions： The ventilated intra-abdominal pressure level in patients with AECOPD is increased with increasing pressure of NPPV; medium pressure of noninvasive positive pressure ventilation can improve the dyspnea and arterial blood gas level, reduce the incidence of adverse reactions.

关 键 词：AECOPD NPPV IPAP 腹内压 

分 类 号：R563[医药卫生—呼吸系统]