无创正压通气治疗重叠综合征并发肺性脑病

发布时间：2018-03-29 03:09

本文选题：无创正压通气　切入点：重叠综合征　出处：《实用医学杂志》2017年08期

【摘要】：目的:探讨无创正压通气在重叠综合征(阻塞性睡眠呼吸暂停低通气综征合并慢性阻塞性肺疾病)并发肺性脑病患者治疗中的价值。方法:纳入56例重叠综合征并发肺性脑病患者作为研究对象,随机分为试验组和对照组:试验组40例,采用临床常规治疗+无创正压通气治疗;对照组16例,仅采用临床常规治疗,包括吸氧、抗感染、化痰、解痉平喘、糖皮质激素应用、营养支持、对症等治疗。比较两组入院时、入院后2、24 h动脉血气分析(p H、Pa CO2),比较入院后24 h患者意识障碍改善率、气管插管率。结果:入院时动脉血气分析(p H、Pa CO2)两组间比较,差异无统计学意义(P0.05),具有可比性;入院后2、24 h动脉血气分析(p H、Pa CO2)试验组较对照组明显改善,差异有统计学意义(P0.05)。入院后24 h患者意识障碍改善率试验组高于对照组(P0.05);入院后24 h气管插管率试验组低于对照组(P0.05)。结论:无创正压通气治疗能够纠正重叠综合征并发肺性脑病患者缺氧和二氧化碳潴留,提高意识障碍改善率,减少气管插管率。
[Abstract]:Objective: to investigate the value of noninvasive positive pressure ventilation in the treatment of overlapped syndrome (obstructive sleep apnea-hypopnea syndrome combined with chronic obstructive pulmonary disease) complicated with pulmonary encephalopathy. Methods: 56 cases of overlap syndrome were included. Patients with pulmonary encephalopathy were studied. They were randomly divided into trial group (n = 40) and control group (n = 40). The control group (n = 16) was treated with routine clinical therapy, including oxygen inhalation, anti-infection, phlegm, antispasmolysis, glucocorticoid use. Nutritional support and symptomatic treatment. The arterial blood gas analysis was compared between the two groups 24 hours after admission, the improvement rate of consciousness disorder and tracheal intubation rate were compared 24 hours after admission. Results: the arterial blood gas analysis was compared between the two groups on admission. The difference was not statistically significant (P 0.05) and was comparable, and the arterial blood gas analysis at 24 h after admission was significantly improved in the trial group than in the control group. The improvement rate of consciousness disorder in the trial group was higher than that in the control group at 24 hours after admission, and the tracheal intubation rate in the experimental group was lower than that in the control group at 24 hours after admission. Conclusion: the treatment of noninvasive positive pressure ventilation can correct overlap synthesis. Symptoms complicated with pulmonary encephalopathy, hypoxia and carbon dioxide retention, Improve the improvement rate of consciousness disorder and reduce the rate of tracheal intubation.
【作者单位】：华北理工大学附属遵化市人民医院;华北理工大学附属医院;
【基金】：河北省科技厅科技计划项目(编号:15277797D)
【分类号】：R563.9;R747.9;R766

【参考文献】