无创正压通气对AECOPD患者呼吸肌疲劳的治疗作用

发布时间：2018-07-22 13:34

【摘要】：目的采用随机平行对照研究,评价无创正压通气(NPPV)对于轻度慢性阻塞性肺疾病急性加重期(AECOPD)患者早期治疗的效果。方法符合入选标准和排除标准的轻度AECOPD的40例患者,随机分为NPPV组和对照组进行治疗并观察治疗前后血气指标、呼吸肌疲劳指标的改变以及医疗花费情况。结果 NPPV组和对照组的PaCO2和pH值差异无统计学意义。NPPV组在治疗2h时PaO2[(79.81±50.3)mmHg]明显升高,和对照组[(64.29±33.2)mmHg]比较差异有统计学意义。NPPV组膈神经动作电位[(200.67±54.0)μV]较治疗前[(127.03±36.0)μV]以及对照组[(150.53±52.0)μV]显著提高,均有统计学意义。NPPV组6min步行距离[(400.25±70.5)m]较治疗前增加,和对照组[(338.41±70.9)m]比较差异有统计学意义。NPPV组的住院天数缩短,但同时治疗花费也增多,和对照组比较差异均有统计学意义。结论 NPPV对轻度AECOPD患者早期干预治疗后可以改善PaO2,缓解呼吸肌疲劳,提高活动耐力,但对PaCO2和pH值无改善。
[Abstract]:Objective to evaluate the effect of noninvasive positive pressure ventilation (NPPV) on early treatment of patients with mild acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods 40 patients with mild AECOPD who met the inclusion criteria and exclusion criteria were randomly divided into NPPV group and control group to observe the changes of blood gas index, respiratory muscle fatigue index and medical expenses before and after treatment. Results there was no significant difference in Paco _ 2 and pH between NPPV group and control group. Pao _ 2 [(79.81 卤50.3) mm Hg] was significantly increased in NPPV group at 2h after treatment, and significantly higher than that in control group [(64.29 卤33.2) mm Hg]. The phrenic action potential [(200.67 卤54.0) 渭 V] in NPPV group was significantly higher than that in pre-treatment [(127.03 卤36.0) 渭 V] and control group [(150.53 卤52.0) 渭 V]. The walking distance of 6min in the NPPV group [(400.25 卤70.5) m] was significantly higher than that in the control group [(338.41 卤70.9) m]. The hospitalization days of the NPPV group were significantly shorter than that of the control group [(338.41 卤70.9) m], but the treatment cost was also increased, and the difference was statistically significant compared with the control group. Conclusion NPPV can improve PaO2, relieve respiratory muscle fatigue and improve activity endurance after early intervention in mild AECOPD patients, but it does not improve Paco _ 2 and pH value.
【作者单位】：西安交通大学医学院第一附属医院呼吸与危重症医学科;西安交通大学医学院第一附属医院神经内科;西安交通大学医学院第一附属医院心内科;
【基金】：陕西省科技发展计划项目(No.2008K14-08)~~
【分类号】：R563.9

【参考文献】