实用心脑肺血管病杂志
實用心腦肺血管病雜誌
실용심뇌폐혈관병잡지
PRACTICAL JOURNAL OF CARDIAC CEREBRAL PNEUMAL AND VASCULAR DISEASE
2015年
3期
22-24
,共3页
肺疾病,慢性阻塞性%通气机,机械%连续气道正压通气%治疗结果
肺疾病,慢性阻塞性%通氣機,機械%連續氣道正壓通氣%治療結果
폐질병,만성조새성%통기궤,궤계%련속기도정압통기%치료결과
Pulmonary disease,chronic obstructive%Ventilators,mechanical%Continuous positive airway pressure%Treatment outcome
目的：探讨不同压力支持水平无创正压通气治疗慢性阻塞性肺疾病急性加重期（ AECOPD）的临床效果。方法选择2012年1月—2014年1月在中国人民解放军第二五五医院住院治疗的AECOPD患者88例，随机分为高压组和低压组，每组44例。两组患者入院后均给予常规治疗和无创正压通气治疗，高压组患者吸气正压（ IPAP）为15~19 cm H2 O，低压组为10~14 cm H2 O。观察两组患者治疗前，治疗后1、3、7 d腹内压、中心静脉压、平均动脉压、氧分压、氧合指数、二氧化碳分压变化，记录并发症情况。结果两组患者治疗前腹内压、中心静脉压、平均动脉压、氧分压、氧合指数、二氧化碳分压比较，差异均无统计学意义（ P>0.05）；低压组患者治疗后7 d腹内压低于高压组，治疗后1、3、7d氧分压低于高压组，治疗后3、7d氧合指数低于高压组，治疗后1、3、7d二氧化碳分压高于高压组（P<0.05）。高压组患者并发症发生率为59.1%，低压组为54.5%，差异无统计学意义（P>0.05）。结论较高压力支持水平（ IPAP 15~19 cm H2 O）的无创正压通气治疗AECOPD安全有效，可更好地改善患者通气功能，且不会增加并发症发生风险。
目的：探討不同壓力支持水平無創正壓通氣治療慢性阻塞性肺疾病急性加重期（ AECOPD）的臨床效果。方法選擇2012年1月—2014年1月在中國人民解放軍第二五五醫院住院治療的AECOPD患者88例，隨機分為高壓組和低壓組，每組44例。兩組患者入院後均給予常規治療和無創正壓通氣治療，高壓組患者吸氣正壓（ IPAP）為15~19 cm H2 O，低壓組為10~14 cm H2 O。觀察兩組患者治療前，治療後1、3、7 d腹內壓、中心靜脈壓、平均動脈壓、氧分壓、氧閤指數、二氧化碳分壓變化，記錄併髮癥情況。結果兩組患者治療前腹內壓、中心靜脈壓、平均動脈壓、氧分壓、氧閤指數、二氧化碳分壓比較，差異均無統計學意義（ P>0.05）；低壓組患者治療後7 d腹內壓低于高壓組，治療後1、3、7d氧分壓低于高壓組，治療後3、7d氧閤指數低于高壓組，治療後1、3、7d二氧化碳分壓高于高壓組（P<0.05）。高壓組患者併髮癥髮生率為59.1%，低壓組為54.5%，差異無統計學意義（P>0.05）。結論較高壓力支持水平（ IPAP 15~19 cm H2 O）的無創正壓通氣治療AECOPD安全有效，可更好地改善患者通氣功能，且不會增加併髮癥髮生風險。
목적：탐토불동압력지지수평무창정압통기치료만성조새성폐질병급성가중기（ AECOPD）적림상효과。방법선택2012년1월—2014년1월재중국인민해방군제이오오의원주원치료적AECOPD환자88례，수궤분위고압조화저압조，매조44례。량조환자입원후균급여상규치료화무창정압통기치료，고압조환자흡기정압（ IPAP）위15~19 cm H2 O，저압조위10~14 cm H2 O。관찰량조환자치료전，치료후1、3、7 d복내압、중심정맥압、평균동맥압、양분압、양합지수、이양화탄분압변화，기록병발증정황。결과량조환자치료전복내압、중심정맥압、평균동맥압、양분압、양합지수、이양화탄분압비교，차이균무통계학의의（ P>0.05）；저압조환자치료후7 d복내압저우고압조，치료후1、3、7d양분압저우고압조，치료후3、7d양합지수저우고압조，치료후1、3、7d이양화탄분압고우고압조（P<0.05）。고압조환자병발증발생솔위59.1%，저압조위54.5%，차이무통계학의의（P>0.05）。결론교고압력지지수평（ IPAP 15~19 cm H2 O）적무창정압통기치료AECOPD안전유효，가경호지개선환자통기공능，차불회증가병발증발생풍험。
Objective To investigate the clinical effect of non-invasive positive pressure ventilation( NIPPV) with different inhale positive airway pressures(IPAP)on acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods A total of 88 AECOPD patients were selected in the 255th Hospital of Chinese People′s Liberation Army from January 2012 to January 2014,and they were randomly divided into groups A and B,each of 44 cases. Both groups given conventional therapy and NIPPV,while the IPAP of A group was from 15 to 19 cm H2 O,that of B group was from 10 to 14 cm H2 O. Intra-abdominal pressure( IAP),central venous pressure( CVP),mean arterial pressure( MAP),PO2 ,oxygenation index( OI), PCO2 were compared between the two groups before treatment and 1 day,3 days,7 days after treatment,incidence of complications was recorded. Results No statistically significant differences of IAP,CVP,MAP,PO2 ,OI,PCO2 was found between the two groups before treatment(P>0. 05);while IAP of B group was lower than that of A group 7 days after treatment (P<0. 05),PO2 was lower than that of A group 1 day,3 days,7 days after treatment,respectively(P <0. 05),OI was lower than that of A group 3 days,7 days after treatment,respectively(P<0. 05),PCO2 was higher than that of A group 1 day,3 days,7 days after treatment,respectively(P<0. 05). The incidence of complications of A group was 59. 1%,that of B group was 54. 5%,the difference was not statistically significant(P>0. 05). Conclusion Higher IPAP(from 15 to 19 cm H2 O) of NIPPV is safe and effective in treating AECOPD,can preferably improve the respiratory function,without increasing the risk of complications.
