无创呼吸机对肺源性心脏病合并Ⅱ型呼吸衰竭临床效果观察  

Clinical Effect of Noninvasive Ventilator in Treatment of Patients with Cor Pulmonale Complicated with Type Ⅱ Respiratory Failure

作　　者：张静[1] 苏江华[2] 杨会芳[3] 王霞[2] ZHANG Jing;SU Jiang-huab;YANG Hui-fang;WANG Xia(Department of Cardiothoracic Surgery,the Second Hospital of Shijiazhuang,Shijiazhuang 050000,China;Department of Respiratory Medicine,the Second Hospital of Shijiazhuang,Shijiazhuang 050000,China;Department of Neurology,the Second Hospital of Shijiazhuang,Shijiazhuang 050000,China)

机构地区：[1]石家庄市第二医院心胸外科,石家庄050000 [2]石家庄市第二医院呼吸内科,石家庄050000 [3]石家庄市第二医院神经内科,石家庄050000

出　　处：《解放军医药杂志》2019年第1期33-35,53,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：河北省卫生厅科研基金项目(20181267)

摘　　要：目的观察Bi PAP无创呼吸机对肺源性心脏病合并Ⅱ型呼吸衰竭的临床效果。方法选择2017年6月—2018年1月收治的肺源性心脏病合并Ⅱ型呼吸衰竭66例的临床资料进行回顾性分析,按治疗方法分为观察组35例和对照组31例。对照组给予常规治疗,观察组在常规治疗基础上使用Bi PAP无创呼吸机。比较2组心率、呼吸频率、血压及动脉血气分析指标,测定血脑钠肽(BNP)、内皮素-1(ET-1)、肿瘤坏死因子-α(TNF-α)及白介素-8(IL-8)水平,并记录呼吸困难、胸闷心悸、咳嗽缓解时间。结果 2组治疗后心率、呼吸频率、平均动脉压、二氧化碳分压均较治疗前降低,氧分压和血氧饱和度均较治疗前升高,且观察组改善情况优于对照组(P <0. 05)。观察组呼吸困难、胸闷心悸及剧烈咳嗽缓解时间短于对照组(P <0. 05)。2组治疗后BNP、ET-1、TNF-α及IL-8均较治疗前降低,且观察组低于治疗组(P <0. 05)。结论 Bi PAP无创呼吸机对肺源性心脏病合并Ⅱ型呼吸衰竭效果可靠。Objective To observe clinical effect of BiPAP noninvasive ventilator in treatment of patients with cor pulmonale complicated with typeⅡrespiratory failure.Methods Clinical data of 66 patients with cor pulmonale complicated with typeⅡrespiratory failure admitted during June 2017 and January 2018 was retrospectively analyzed,and the patients were divided into observation group(n=35)and control group(n=31)according to therapeutic methods.Control group received conventional treatment,while observation group was treated with BiPAP noninvasive ventilator on the basis of conventional treatment.In two groups,values of heart rate,respiratory rate,blood pressure and arterial blood gas analysis indexes were compared;levels of blood brain natriuretic peptide(BNP),endothelin-1(ET-1),tumor necrosis factor-alpha(TNF-α)and interleukin-8(IL-8)were detected;relief times of dyspnea,chest distress,palpitations and cough were recorded.Results After treatment,levels of heart rate,respiratory rate,mean arterial pressure and carbon dioxide partial pressure were significantly decreased,while levels of oxygen partial pressure and blood oxygen saturation were significantly increased compared with those before treatment in two groups,and improvement conditions of the above indexes in observation group were significantly better than those in control group(P<0.05).Relief times of dyspnea,chest distress,palpitations and severe cough in observation group were significantly shorter than those in control group(P<0.05).After treatment,BNP,ET-1,TNF-αand IL-8 levels were significantly decreased compared with those before treatment in two groups,and the levels in control group were significantly lower than those in observation group(P<0.05).Conclusion BiPAP Noninvasive ventilator is effective and safe in treatment of patients with cor pulmonale complicated with typeⅡrespiratory failure.

关 键 词：肺心病 呼吸功能不全 无创呼吸机 

分 类 号：R541.5[医药卫生—心血管疾病]