无创呼吸机对肺源性心脏病合并Ⅱ型呼吸衰竭临床效果观察
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摘要
目的观察Bi PAP无创呼吸机对肺源性心脏病合并Ⅱ型呼吸衰竭的临床效果。方法选择2017年6月—2018年1月收治的肺源性心脏病合并Ⅱ型呼吸衰竭66例的临床资料进行回顾性分析,按治疗方法分为观察组35例和对照组31例。对照组给予常规治疗,观察组在常规治疗基础上使用Bi PAP无创呼吸机。比较2组心率、呼吸频率、血压及动脉血气分析指标,测定血脑钠肽(BNP)、内皮素-1(ET-1)、肿瘤坏死因子-α(TNF-α)及白介素-8(IL-8)水平,并记录呼吸困难、胸闷心悸、咳嗽缓解时间。结果 2组治疗后心率、呼吸频率、平均动脉压、二氧化碳分压均较治疗前降低,氧分压和血氧饱和度均较治疗前升高,且观察组改善情况优于对照组(P <0. 05)。观察组呼吸困难、胸闷心悸及剧烈咳嗽缓解时间短于对照组(P <0. 05)。2组治疗后BNP、ET-1、TNF-α及IL-8均较治疗前降低,且观察组低于治疗组(P <0. 05)。结论 Bi PAP无创呼吸机对肺源性心脏病合并Ⅱ型呼吸衰竭效果可靠。
Objective To observe clinical effect of BiPAP noninvasive ventilator in treatment of patients with cor pulmonale complicated with type Ⅱ respiratory failure. Methods Clinical data of 66 patients with cor pulmonale complicated with type Ⅱ respiratory failure admitted during June 2017 and January 2018 was retrospectively analyzed,and the patients were divided into observation group( n = 35) and control group( n = 31) according to therapeutic methods.Control group received conventional treatment,while observation group was treated with BiPAP noninvasive ventilator on the basis of conventional treatment. In two groups,values of heart rate,respiratory rate,blood pressure and arterial blood gas analysis indexes were compared; levels of blood brain natriuretic peptide( BNP),endothelin-1( ET-1),tumor necrosis factor-alpha( TNF-α) and interleukin-8( IL-8) were detected; relief times of dyspnea,chest distress,palpitations and cough were recorded. Results After treatment,levels of heart rate,respiratory rate,mean arterial pressure and carbon dioxide partial pressure were significantly decreased,while levels of oxygen partial pressure and blood oxygen saturation were significantly increased compared with those before treatment in two groups,and improvement conditions of the above indexes in observation group were significantly better than those in control group( P < 0. 05). Relief times of dyspnea,chest distress,palpitations and severe cough in observation group were significantly shorter than those in control group( P < 0. 05). After treatment,BNP,ET-1,TNF-α and IL-8 levels were significantly decreased compared with those before treatment in two groups,and the levels in control group were significantly lower than those in observation group( P < 0. 05). Conclusion BiPAP Noninvasive ventilator is effective and safe in treatment of patients with cor pulmonale complicated with type Ⅱ respiratory failure.
Objective To observe clinical effect of BiPAP noninvasive ventilator in treatment of patients with cor pulmonale complicated with type Ⅱ respiratory failure. Methods Clinical data of 66 patients with cor pulmonale complicated with type Ⅱ respiratory failure admitted during June 2017 and January 2018 was retrospectively analyzed,and the patients were divided into observation group( n = 35) and control group( n = 31) according to therapeutic methods.Control group received conventional treatment,while observation group was treated with BiPAP noninvasive ventilator on the basis of conventional treatment. In two groups,values of heart rate,respiratory rate,blood pressure and arterial blood gas analysis indexes were compared; levels of blood brain natriuretic peptide( BNP),endothelin-1( ET-1),tumor necrosis factor-alpha( TNF-α) and interleukin-8( IL-8) were detected; relief times of dyspnea,chest distress,palpitations and cough were recorded. Results After treatment,levels of heart rate,respiratory rate,mean arterial pressure and carbon dioxide partial pressure were significantly decreased,while levels of oxygen partial pressure and blood oxygen saturation were significantly increased compared with those before treatment in two groups,and improvement conditions of the above indexes in observation group were significantly better than those in control group( P < 0. 05). Relief times of dyspnea,chest distress,palpitations and severe cough in observation group were significantly shorter than those in control group( P < 0. 05). After treatment,BNP,ET-1,TNF-α and IL-8 levels were significantly decreased compared with those before treatment in two groups,and the levels in control group were significantly lower than those in observation group( P < 0. 05). Conclusion BiPAP Noninvasive ventilator is effective and safe in treatment of patients with cor pulmonale complicated with type Ⅱ respiratory failure.
引文
[1]张瑛,唐群科,袁春萍,等.阿魏酸钠对高原慢性肺源性心脏病急性加重期患者高凝状态的影响[J].中国综合临床,2014,30(4):387-389.
[2]卢云,金伟,张晓云,等.中西医结合治疗肺心病急性发作期120例临床观察[J].中国临床医生,2014,42(5):71-75.
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[6]展翼翼,姜芸,谢姆孜牙·买买提热夏提,等.有创机械通气与无创机械通气治疗肺动脉高压并呼吸衰竭临床疗效的比较研究[J].实用心脑肺血管病杂志,2016,24(3):60-62.
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[8]郑琨,文琼.无创呼吸机辅助通气治疗COPD并Ⅱ型呼吸衰竭50例[J].中国医药指南,2014,18(30):143-144.
[9]牛毅.有创-无创序贯性机械通气治疗高海拔地区慢性肺源性心脏病急性加重期伴Ⅱ型呼吸衰竭患者的适应证[J].中国老年学杂志,2015,12(4):1076-1077.
[10]何滨. Bi PAP呼吸机无创辅助通气治疗老年慢性肺源性心脏病并发Ⅱ型呼吸衰竭临床探讨[J].中外医学研究,2016,14(2):138-139.
[11]张雪倩,余盛玲,陈欧丽.循证护理配合雾化吸入对老年肺源性心脏病患者肺功能和自护能力的影响[J].中国循证心血管医学杂志,2016,8(5):607-609.
[12]林秾威,林福筹.电子纤维支气管镜肺泡灌洗联合雾化吸入治疗COPD肺源性心脏病合并肺部感染的临床研究[J].临床医学,2016,36(7):8-10.
[13]雷应军,胡振红,刘海潮,等.无创正压通气对COPD合并肺源性心脏急性加重期患者疗效和血气、炎性指标的影响[J].疑难病杂志,2016,15(3):233-235.
[14]董新华,夏荣荣.无创通气治疗COPD合并重症呼吸衰竭36例疗效观察[J].中国医学创新,2011,8(28):30-31.
[15]谢红伟.无创机械通气对慢性肺心病并发呼吸衰竭患者血浆脑钠钛及内皮素水平的影响[J].河南医学研究,2016,25(9):1636-1637.
[16]方利洲,梁晓.无创机械通气对老年慢性肺心病伴呼吸衰竭患者脑钠肽、内皮素-1水平的影响[J].中国老年学杂志,2015,35(24):7100-7101.
[17]付祥玲,任金林.无创机械通气治疗慢性肺源性心脏病合并Ⅱ型呼吸衰竭的临床疗效研究[J].实用心脑肺血管病杂志,2016,27(1):147.
[18]赵明玺.无创机械通气对慢性肺心病并发呼吸衰竭患者血浆脑钠钛及内皮素水平的影响观察[J].基层医学论坛,2016,20(30):4197-4198.
[19]邓赶飞,安晓洁.无创机械通气(NIMV)治疗慢性肺源性心脏病(CPHD)合并Ⅱ型呼吸衰竭的临床疗效观察[J].中国医药指南,2015,13(19):71-72.
[20]毛丽梅,刘海峰,郝继恒.阿托伐他汀对慢性肺源性心脏病患者血浆白细胞介素6、肿瘤坏死因子α的影响[J].中国综合临床,2014,30(3):225-228.
[21]周松林,徐文波.无创机械通气治疗慢性肺源性心脏病合并Ⅱ型呼吸衰竭的临床疗效[J].中国现代医学杂志,2015,25(12):106-109.
[2]卢云,金伟,张晓云,等.中西医结合治疗肺心病急性发作期120例临床观察[J].中国临床医生,2014,42(5):71-75.
[3]杨欣,任斌辉,许林,等.脑利钠肽BNP的临床应用进展[J].现代生物医学进展,2013,13(4):775-777,771.
[4]何喜军,石源.脑钠肽在慢性阻塞性肺疾病合并呼吸衰竭患者中的应用[J].海南医学,2013,24(8):1180-1182.
[5]陈俊东,郑利先,罗巍,等.无创机械通气用于COPD呼吸衰竭患者治疗效果观察[J].山东医药,2015,55(14):78-79.
[6]展翼翼,姜芸,谢姆孜牙·买买提热夏提,等.有创机械通气与无创机械通气治疗肺动脉高压并呼吸衰竭临床疗效的比较研究[J].实用心脑肺血管病杂志,2016,24(3):60-62.
[7]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中华结核和呼吸杂志,2013,36(4):255-264.
[8]郑琨,文琼.无创呼吸机辅助通气治疗COPD并Ⅱ型呼吸衰竭50例[J].中国医药指南,2014,18(30):143-144.
[9]牛毅.有创-无创序贯性机械通气治疗高海拔地区慢性肺源性心脏病急性加重期伴Ⅱ型呼吸衰竭患者的适应证[J].中国老年学杂志,2015,12(4):1076-1077.
[10]何滨. Bi PAP呼吸机无创辅助通气治疗老年慢性肺源性心脏病并发Ⅱ型呼吸衰竭临床探讨[J].中外医学研究,2016,14(2):138-139.
[11]张雪倩,余盛玲,陈欧丽.循证护理配合雾化吸入对老年肺源性心脏病患者肺功能和自护能力的影响[J].中国循证心血管医学杂志,2016,8(5):607-609.
[12]林秾威,林福筹.电子纤维支气管镜肺泡灌洗联合雾化吸入治疗COPD肺源性心脏病合并肺部感染的临床研究[J].临床医学,2016,36(7):8-10.
[13]雷应军,胡振红,刘海潮,等.无创正压通气对COPD合并肺源性心脏急性加重期患者疗效和血气、炎性指标的影响[J].疑难病杂志,2016,15(3):233-235.
[14]董新华,夏荣荣.无创通气治疗COPD合并重症呼吸衰竭36例疗效观察[J].中国医学创新,2011,8(28):30-31.
[15]谢红伟.无创机械通气对慢性肺心病并发呼吸衰竭患者血浆脑钠钛及内皮素水平的影响[J].河南医学研究,2016,25(9):1636-1637.
[16]方利洲,梁晓.无创机械通气对老年慢性肺心病伴呼吸衰竭患者脑钠肽、内皮素-1水平的影响[J].中国老年学杂志,2015,35(24):7100-7101.
[17]付祥玲,任金林.无创机械通气治疗慢性肺源性心脏病合并Ⅱ型呼吸衰竭的临床疗效研究[J].实用心脑肺血管病杂志,2016,27(1):147.
[18]赵明玺.无创机械通气对慢性肺心病并发呼吸衰竭患者血浆脑钠钛及内皮素水平的影响观察[J].基层医学论坛,2016,20(30):4197-4198.
[19]邓赶飞,安晓洁.无创机械通气(NIMV)治疗慢性肺源性心脏病(CPHD)合并Ⅱ型呼吸衰竭的临床疗效观察[J].中国医药指南,2015,13(19):71-72.
[20]毛丽梅,刘海峰,郝继恒.阿托伐他汀对慢性肺源性心脏病患者血浆白细胞介素6、肿瘤坏死因子α的影响[J].中国综合临床,2014,30(3):225-228.
[21]周松林,徐文波.无创机械通气治疗慢性肺源性心脏病合并Ⅱ型呼吸衰竭的临床疗效[J].中国现代医学杂志,2015,25(12):106-109.