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无创机械通气治疗慢性阻塞性肺疾病合并呼吸衰竭对患者心功能的影响
易小萍,蔡耀婷,邓学学
0
(四川大学华西医院全科医学科)
摘要:
【摘要】 目的 观察无创机械通气治疗对慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者心功能及心电图影响。方法 86例COPD合并呼吸衰竭患者按照治疗方式不同分为观察组和对照组,每组各43例。对照组接受常规治疗,观察组在常规治疗基础上给予无创机械通气治疗。治疗1周后比较两组动脉血气指标(HR、RR、PH、PaO2、PaCO2),心功能指标(LVEF、cTnI、BNP、ProBNP),APACHEⅡ评分,心电图P波变化情况,住院天数、气管插管次数和住院费用及并发症发生情况。结果 治疗观察组HR、RR、PaCO2、cTnI、BNP、proBNP指标、APACHEⅡ评分、Pmax和Pwd较对照组降低(P<005),而PH、PaO2、LVEF指标较对照组升高(P<005)。观察组在住院天数、气管插管次数和住院费用低于对照组(P<005),而两组并发症发生比较差异无统计学意义(P>005)。结论 无创机械通气能够改善COPD合并呼吸衰竭患者通气效率、血气分析指标、心功能指标,同时具有无创、使用简便、并发症少等优点,可在临床推广使用。
关键词:  无创机械通气  慢性阻塞性肺病  呼吸衰竭  心功能
DOI:
基金项目:
Effect of noninvasive mechanical ventilation on cardiac function in patients with chronic obstructive pulmonary disease complicated with respiratory failure
YI Xiaoping,CAI Yaoting,DENG Xuexue
(Department of General Surgery, West China Hospital, Sichuan University)
Abstract:
【Abstract】 Objective To observe the effect of noninvasive mechanical ventilation on cardiac function and electrocardiogram (ECG) of patients with chronic obstructive pulmonary disease (COPD) complicated with respiratory failure. Methods 86 patients with COPD complicated with respiratory failure were divided into the observation group and the control group by random number table method, 43 cases in each group. The control group was given conventional treatment, while the observation group was given noninvasive mechanical ventilation, on the basis of conventional treatment. The arterial blood gas indexes (HR, RR, PH, PaO2, PaCO2), cardiac function indexes (LVEF, cTnI, BNP, ProBNP), APACHE score, changes in P wave of ECG, the length of hospital day, times of tracheal intubation, hospitalization expenses and incidence of related complications were compared between the two groups. Results After treatment, the HR, RR, PaCO2, cTnI, BNP, ProBNP, APACHE score, Pmax and Pwd of the observation group were significantly lower than those of the control group (P<005), while PH, PaO2 and LVEF were significantly higher than those of the control group (P<005). The length of hospital stay, times of tracheal intubation and hospitalization expenses of the observation group were significantly shorter and less than those of the control group (P<005). There was no significant difference in the incidence of complications between the two groups (P>005). Conclusion Noninvasive mechanical ventilation can improve the ventilation efficiency, blood gas analysis indexes and cardiac function indexes in patients with COPD complicated with respiratory failure. It is noninvasive and convenient, with few complications.
Key words:  Noninvasive mechanical ventilation  Chronic obstructive pulmonary disease  Respiratory failure  Cardiac function

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