疑难病杂志
疑難病雜誌
의난병잡지
JOURNAL OF DIFFICULT AND COMPLICATED CASES
2014年
7期
677-679
,共3页
慢性阻塞性肺疾病%阻塞性睡眠呼吸暂停综合征%正压通气%临床特点
慢性阻塞性肺疾病%阻塞性睡眠呼吸暫停綜閤徵%正壓通氣%臨床特點
만성조새성폐질병%조새성수면호흡잠정종합정%정압통기%림상특점
Chronic obstructive pulmonary disease%Obstructive sleep apnea syndrome%Positive pressure ventilation%Clinical characteristics
目的：观察慢性阻塞性肺疾病（ COPD）合并阻塞性睡眠呼吸暂停综合征（ OSAS）患者临床特点，并探讨正压通气的治疗效果。方法 COPD患者100例，其中COPD合并OSAS患者48例作为观察组，单纯COPD患者52例为对照组；对比2组患者常规肺功能及临床特点，睡眠呼吸监测结果；观察组患者采用正压通气治疗，治疗6周后观察患者的临床疗效。结果与对照组比较，观察组患者体质量较大[分别为（61．4±7．1）kg、（72．1±8．8）kg]，一秒钟呼气容积/肺活量（FEV1/FVC）、动脉血氧分压（PaO2）、血氧饱和度（SaO2）降低（ P ＜0．05），二氧化碳分压（PaCO2）及pH值无显著差异（ P ＞0．05）。睡眠呼吸监测结果表明，与对照组比较，观察组睡眠潜伏期缩短，低氧血症明显，呼吸紊乱严重，除总睡眠时间（TST）外，其余各项指标差异均有统计学意义（ P ＜0．05）。观察组治疗后呼吸中枢低氧反应性升高（ P ＜0．05），而高二氧化碳反应性无显著变化（ P ＞0．05）。结论采用正压通气治疗可消除呼吸暂停，提高睡眠质量，改善氧分压，以及提高患者预后。
目的：觀察慢性阻塞性肺疾病（ COPD）閤併阻塞性睡眠呼吸暫停綜閤徵（ OSAS）患者臨床特點，併探討正壓通氣的治療效果。方法 COPD患者100例，其中COPD閤併OSAS患者48例作為觀察組，單純COPD患者52例為對照組；對比2組患者常規肺功能及臨床特點，睡眠呼吸鑑測結果；觀察組患者採用正壓通氣治療，治療6週後觀察患者的臨床療效。結果與對照組比較，觀察組患者體質量較大[分彆為（61．4±7．1）kg、（72．1±8．8）kg]，一秒鐘呼氣容積/肺活量（FEV1/FVC）、動脈血氧分壓（PaO2）、血氧飽和度（SaO2）降低（ P ＜0．05），二氧化碳分壓（PaCO2）及pH值無顯著差異（ P ＞0．05）。睡眠呼吸鑑測結果錶明，與對照組比較，觀察組睡眠潛伏期縮短，低氧血癥明顯，呼吸紊亂嚴重，除總睡眠時間（TST）外，其餘各項指標差異均有統計學意義（ P ＜0．05）。觀察組治療後呼吸中樞低氧反應性升高（ P ＜0．05），而高二氧化碳反應性無顯著變化（ P ＞0．05）。結論採用正壓通氣治療可消除呼吸暫停，提高睡眠質量，改善氧分壓，以及提高患者預後。
목적：관찰만성조새성폐질병（ COPD）합병조새성수면호흡잠정종합정（ OSAS）환자림상특점，병탐토정압통기적치료효과。방법 COPD환자100례，기중COPD합병OSAS환자48례작위관찰조，단순COPD환자52례위대조조；대비2조환자상규폐공능급림상특점，수면호흡감측결과；관찰조환자채용정압통기치료，치료6주후관찰환자적림상료효。결과여대조조비교，관찰조환자체질량교대[분별위（61．4±7．1）kg、（72．1±8．8）kg]，일초종호기용적/폐활량（FEV1/FVC）、동맥혈양분압（PaO2）、혈양포화도（SaO2）강저（ P ＜0．05），이양화탄분압（PaCO2）급pH치무현저차이（ P ＞0．05）。수면호흡감측결과표명，여대조조비교，관찰조수면잠복기축단，저양혈증명현，호흡문란엄중，제총수면시간（TST）외，기여각항지표차이균유통계학의의（ P ＜0．05）。관찰조치료후호흡중추저양반응성승고（ P ＜0．05），이고이양화탄반응성무현저변화（ P ＞0．05）。결론채용정압통기치료가소제호흡잠정，제고수면질량，개선양분압，이급제고환자예후。
Objective To observe the clinical features of chronic obstructive pulmonary disease ( COPD ) patients with obstructive sleep apnea syndrome ( OSAS) , and to explore the therapeutic effect of positive pressure ventilation .Methods There were 100 patients with COPD , including COPD with OSAS of 48 cases as the observation group , the patients with COPD of 52 cases as the control group;and the clinical characteristics of monitoring results of routine lung function , respirato-ry sleep were compared between the 2 groups; the observation group were treated by positive pressure ventilation , and ob-served the clinical effect of the treatment of patients with after 6 weeks of treatment .Results Compared with the control group, observation group patients'mass were larger than control group , [(61.4 ±7.1 kg) and (72.1 ±8.8 kg)], one second expiratory volume/vital capacity (FEV1/FVC), arterial partial pressure of oxygen( PaO2), oxygen saturation (SaO2) were decreased( P <0.05), partial pressure of carbon dioxide( PaCO2) and pH value had no significant difference ( P >0.05). Respiratory sleep monitoring results shows that , compared with the control group , the observation group sleep latency , hypo-xemia was obvious , respiratory disorder , in addition to total sleep time ( TST) , other indexes of the differences were statisti-cally significant ( P <0.05).The central response to hypoxia was increased after treatment in the observation group ( P <0.05), while no significant change in high carbon dioxide reactivity ( P >0.05).Conclusion The positive pressure ventila-tion treatment can eliminate apnea , improve sleep quality , improve the oxygen partial pressure , and improve the prognosis of the patients .
