带面罩的呼气控制装置治疗慢性阻塞性肺疾病的临床观察  

Clinical observation of treatment used for expiration control device with mask for chronic obstructive pulmonary disease

作　　者：刘斌[1] 秦建文[1] 李文全[1] 

机构地区：[1]天津市胸科医院呼吸与危重症科,300222

出　　处：《实用医学杂志》2017年第13期2169-2173,共5页The Journal of Practical Medicine

摘　　要：目的检验笔者自行研制的带面罩的呼气控制装置治疗慢性阻塞性肺疾病(COPD)的疗效。方法接受带面罩的呼气控制装置治疗的102例患者中50例患者使用该装置的呼气末正压功能治疗,另外52例患者使用该装置的呼气延阻功能治疗,观察治疗前后患者动脉血气分析中二氧化碳分压(PaCO_2)、氧分压(PaO_2)、pH值及肺功能中用力肺活量(FVC)、一秒量(FEV1)、潮气量(VT)差异。结果(1)呼气末正压治疗组治疗前后肺功能FVC、FEV1、VT(2.95±0.32)L vs(3.22±0.35)L,(1.88±0.17)L vs(2.00±0.15)L,(335.28±43.59)mL vs(364.64±44.28)mL(均P<0.01)差异有统计学意义;动脉血PaCO_2,PaO_2,pH(50.42±4.77)mmHg vs(48.42±3.76)mmHg,(65.42±4.60)mmHg vs(68.50±4.69)mmHg,(7.35±0.030)vs(7.37±0.037)(均P<0.05)差异有统计学意义;(2)呼气延阻治疗组治疗前后肺功能FVC、FEV1、VT(2.93±0.22)L vs(3.10±0.27)L,(1.83±0.14)L vs(1.91±0.16)L,(335.48±44.16)mL vs(362.46±38.66)mL(均P<0.05)差异有统计学意义;动脉血PaCO_2,PaO_2,pH(52.39±3.37)mmHg vs(50.06±3.92)mmHg,(68.05±3.80)mmHg vs(68.99±4.57)mmHg,(7.34±0.035)vs(7.37±0.036)(均P<0.05)差异有统计学意义。结论带面罩的呼气控制装置能够改善COPD患者通气功能,使用方便、安全有效,具有较高的临床应用价值。Objective To test the clinical effects of the expiration control device with mask in the treatment of chronic obstructive pulmonary disease. This device developed by the author. Methods A total of 102 patients were treated by the device. Among them, 50 patients received positive end-expiratory pressure and 52 with expiratory flow retard and blocked function. Differences in carbon dioxide partial pressure （PaCO2） , oxygen partial pressure （PaO2） and pH of the arterial blood gas analysis were compared, as well as differences in forced vital capacity （FVC）, forced expiratory volume for l sec （FEV1）, tidal volume （VT） of pulmonary function before and after treatment. Results （1） In the positive end-expiratory pressure group, there were significant differences of FVC, FEV1 and VT before and after treatment （2.95 ± 0.32）L vs （3.22 ± 0.35） L, （1.88 ± 0.17）L vs （2.00 ± 0.15）L, （335.28 ± 43.59）mL vs （364.64 _± 44.28）mL, （P 〈 0.01 ）differences of PaCO2, PaO2 and pH before and after treatment had statistical significance （ 50.42 ± 4.77 ） mmHg vs （48.42 ± 3.76） mmHg, （65.42± 4.60） mmHg vs （ 68.50 ± 4.69 ） mmHg, （ 7.35 ± 0.030 ） vs （ 7.37 ± 0.037 ） （P 〈 0.05 ）. （ 2 ） In the expiratory flow retard and blocked group, differences of FVC, FEVlandVT before and after treatment had statistical significance （2.93 ± 0.22） L vs （3.10 ± 0.27） L, （1.83 ± 0.14）L vs （1.91 ± 0.16）L, （335.48 ± 44.16）mL vs （362.46 ± 38.66）mL（P〈0.05）, differences of PaCO2, PaO2 and pH before and after treatment had statistical significance （52.39 ± 3.37）mmHg vs （50.06 ± 3.92）mmHg, （68.05 ± 3.80） mmHg vs （68.99 ± 4.57）mmHg, （7.34 ± 0.035） vs （7.37 ± 0.036） （P〈 0.05）. Conclusion This device can improve the ventilation function in patients with COPD. It is easy to use, safe and effective, with high clinical application value.

关 键 词：慢性阻塞性肺疾病 面罩 外源性呼气末正压 缩唇呼吸 通气功能 

分 类 号：R563.9[医药卫生—呼吸系统]