CAJ | 학술논문

目的探讨双水平气道正压通气(Bi-PAP)治疗重叠综合征合并呼吸衰竭患者的远期疗效.方法选取2009年6月至2010年12月我院收治的38例重叠综合征合并呼吸衰竭的患者,将患者随机分为观察组(n=20)和对照组(n=18).对照组采用常规治疗,观察组加用Bi-PAP治疗.分别于治疗后第1年、第2年以及第3年内进行随访,观察记录每年患者急性加重住院的次数及生存率.并于治疗后第3年对患者的血气指标、肺功能等进行监测.结果观察组患者随访3年时在睡眠呼吸暂停低通气指数、最低血氧饱和度、Epworth评分、pH值、PaO2、PaCO2以及FEV1％ pred等方面均显著优于对照组;2组患者急性加重住院次数均逐年递减,但同时期2组相比较,观察组急性加重住院次数明显低于对照组;在随访第2年及第3年,观察组患者的生存率明显高于对照组,其中,尤以第3年差异最为显著,观察组生存率为65.00％,明显高于对照组(33.33％,x2=9.619,P=0.000).结论 Bi-PAP治疗重叠综合征伴呼吸衰竭患者能够有效地提高治疗效果,改善患者的血气指标及肺功能,延缓病情,降低患者的病死率.
목적 탐토쌍수평기도정압통기(Bi-PAP)치료중첩종합정합병호흡쇠갈환자적원기료효.방법 선취2009년6월지2010년12월아원수치적38례중첩종합정합병호흡쇠갈적환자,장환자수궤분위관찰조(n=20)화대조조(n=18).대조조채용상규치료,관찰조가용Bi-PAP치료.분별우치료후제1년、제2년이급제3년내진행수방,관찰기록매년환자급성가중주원적차수급생존솔.병우치료후제3년대환자적혈기지표、폐공능등진행감측.결과 관찰조환자수방3년시재수면호흡잠정저통기지수、최저혈양포화도、Epworth평분、pH치、PaO2、PaCO2이급FEV1％ pred등방면균현저우우대조조;2조환자급성가중주원차수균축년체감,단동시기2조상비교,관찰조급성가중주원차수명현저우대조조;재수방제2년급제3년,관찰조환자적생존솔명현고우대조조,기중,우이제3년차이최위현저,관찰조생존솔위65.00％,명현고우대조조(33.33％,x2=9.619,P=0.000).결론 Bi-PAP치료중첩종합정반호흡쇠갈환자능구유효지제고치료효과,개선환자적혈기지표급폐공능,연완병정,강저환자적병사솔.
Objective To investigate long-term prognosis of bi level positive airway pressure (Bi-PAP) therapy for overlap syndrome patients with respiratory failure.Methods 38 cases of overlap syndrome with respiratory failure from June 2009 to December 2010 in our hospital were selected,and were divided randomly into observation group (n =20) and control group (n =18).The control group received conventional treatment,and the observation group received Bi-PAP treatment based on conventional treatment.The patients were followed up respectively in the first,second and third year after treatment,and the number of patients hospitalized for acute exacerbations and survival was recorded.In the third year after treatment,the blood gas and pulmonary function of patients were monitored.Results The apnea hypopnea index,lowest nocturnal oxygen saturation,Epworth sleepiness scale,p H value,PaO2,PaCO2,and FEV1％ pred in the observation group were better than those in the control group in the third year after treatment.The times of hospitalization with acute exacerbations in two groups were diminishing,the observation group was significantly lower than the control group.The survival rate of observation group was significantly higher than that of the control group in the second and third year after treatment,especially in the third year the difference was the most significant (65.00％ vs 33.33％,x2=9.619,P =0.000).Conclusions Bi-PAP can effectively improve the therapeutic effect,improve the blood gas analysis and pulmonary function of patients,slow the disease and reduce mortality of overlap syndrome patients with respiratory failure.