痰热清注射液辅助BiPAP治疗对COPD急性呼吸衰竭患者氧代谢、胸肺顺应性及呼吸动力学的影响  

Effects of Tanreqing injection-assisted bi-level positive airway pressure on oxygen metabolism,thorax-lung compliance,and respiratory dynamics in COPD patients with acute respiratory failure

作　　者：侯玮 于菲 孙娟 帖怡凡 HOU Wei;YU Fei;SUN Juan;TIE Yi-fan(Department of Respiratory Medicine,No.215 Hospital of Shaanxi Nuclear Industry,Xianyang 712000,Shaanxi,CHINA;Department of Respiratory and Critical Care Medicine,Baoji Central Hospital,Baoji 721000,Shaanxi,CHINA)

机构地区：[1]陕西省核工业二一五医院呼吸内科,陕西咸阳712000 [2]宝鸡市中心医院呼吸与危重症医学科,陕西宝鸡721000

出　　处：《海南医学》2022年第23期3005-3008,共4页Hainan Medical Journal

基　　金：陕西省宝鸡市卫生和计划生育局科研课题(编号:2017-045)。

摘　　要：目的观察痰热清注射液辅助双水平正压通气(BiPAP)治疗慢性阻塞性肺疾病(COPD)合并急性呼吸衰竭的疗效,并探讨其对患者氧代谢、胸肺顺应性及呼吸动力学的影响。方法选取2018年5月至2020年5月陕西省核工业二一五医院收治的138例COPD伴急性呼吸衰竭患者为研究对象,采用掷硬币随机分组法将患者分为观察组73例和对照组65例。两组患者均接受常规治疗,在此基础上对照组接受BiPAP治疗,观察组接受痰热清注射液联合BiPAP治疗,连续治疗14 d。于治疗后第15天比较两组患者的临床疗效,以及治疗前后的氧代谢、胸肺顺应性和呼吸动力学的变化。结果观察组患者的治疗总有效率为89.04%,明显高于对照组的75.38%,差异有统计学意义(P<0.05);治疗后,观察组患者的动脉氧分压(PaO_(2))、动脉血氧含量(CaO_(2))、总顺应性(Ct)、肺顺应性(Cl)分别为(83.67±6.78)mmHg、(162.63±13.21)mL/L、(362.78±25.56)、(615.74±30.25),明显高于对照组的(77.13±5.82)mmHg、(143.17±12.89)mL/L、(354.33±21.69)、(603.45±38.17),气道阻力(Raw)、气道峰压(PIP)和呼吸做功(WOB)分别为(12.65±3.83)cmH_(2)O·L^(-1)·s^(-1)、(20.49±2.35)cmH_(2)O、(0.55±0.17)J/L,明显低于对照组的(13.87±2.15)cmH_(2)O·L^(-1)·s^(-1)、(21.51±3.17)cmH_(2)O、(0.61±0.13)J/L,差异均有统计学意义(P<0.05);治疗后,两组患者的最大摄氧量(VO_(2))、氧摄取率(ERO_(2))、胸廓顺应性(CTh)比较差异均无统计学意义(P>0.05)。结论在BiPAP治疗COPD急性呼吸衰竭的基础上辅助应用痰热清注射液,能进一步改善患者的氧代谢、胸肺顺应性和呼吸动力学水平,进而提高临床疗效。Objective To observe the effect of Tanreqing injection-assisted bi-level positive airway pressure(BiPAP)in the treatment of chronic obstructive pulmonary disease(COPD)complicated with acute respiratory failure,and investigate the influence on oxygen metabolism,thorax-lung compliance,and respiratory dynamics.Methods A total of 138 patients with COPD complicated with acute respiratory failure who admitted to No.215 Hospital of Shaanxi Nuclear Industry from May 2018 to May 2020 were selected as the research subjects.They were randomly divided into an observation group(n=73)and a control group(n=65)by coin tossing method.Both groups of patients were given conventional treatment.On this basis,the control group was treated with BiPAP,while the observation group was treated with Tanreqing injection-assisted BiPAP,continuously for 14 d.On the 15^(th) day after treatment,the clinical effect,changes of oxygen metabolism,thorax-lung compliance,and respiratory dynamics before and after treatment were compared between the two groups.Results The total treatment response rate in the observation group was 89.04%,which was significantly higher than 75.38%in the control group(P<0.05).After treatment,the levels of arterial partial pressure of oxygen(PaO_(2)),arterial oxygen content(CaO_(2)),total compliance(Ct),and lung compliance(Cl)in the observation group were(83.67±6.78)mmHg,(162.63±13.21)mL/L,362.78±25.56,and 615.74±30.25,which were significantly higher than(77.13±5.82)mmHg,(143.17±12.89)mL/L,354.33±21.69,and 603.45±38.17 in the control group,and the airway resistance(Raw),peak airway pressure(PIP),and work of breathing(WOB)were(12.65±3.83)cmH_(2)O·L^(-1)·S^(-1),(20.49±2.35)cmH_(2)O,and(0.55±0.17)J/L,significantly lower than(13.87±2.15)cmH_(2)O·L^(-1)·S^(-1),(21.51±3.17)cmH_(2)O and(0.61±0.13)J/L in the control group(P<0.05).After treatment,there were no significant differences in maximum oxygen uptake(VO_(2)),oxygen uptake rate(ERO_(2)),and thoracic compliance(CTh)between the two groups(P>0.05).Conclusion Ta

关 键 词：慢性阻塞性肺疾病 呼吸衰竭 双水平正压通气 痰热清注射液 氧代谢 胸肺顺应性 呼吸动力学 

分 类 号：R563.8[医药卫生—呼吸系统]