无创正压通气治疗对COPD合并睡眠呼吸暂停综合征的影响

Effect of Noninvasive Positive Pressure Ventilation on COPD with Sleep Apnea Syndrome

目的探讨无创正压通气治疗慢性阻塞性肺疾病(COPD)的影响。方法以本院为单位,于2017年3月-2018年3月86例COPD合并睡眠呼吸暂停综合征患者,按照入院顺序分为两组,对照组与观察组。对照组43例患者采用常规药物治疗,观察组43例患者采用无创正压通气治疗,比较两组疗效及治疗前后肺功能指标、动脉血气指标、睡眠质量、多导睡眠监测指标,不良反应发生率。结果观察组疗效有效率95.35%高于对照组81.39%(P<0.05);治疗后观察组肺功能指标FEV_(1)、FVC、FEV_(1)/FVC水平,动脉血气指标pH、PaO_(2)水平,SpO_(2)Low水平均高于对照组,而PaCO_(2)水平、多导睡眠监测指标最长呼吸暂停时间、AHI水平低于对照组(P<0.05);治疗后观察组睡眠质量PSQI评分、ESS评分均低于对照组(P<0.05);观察组不良反应发生率9.30%低于对照组27.91%(P<0.05)。结论COPD合并睡眠呼吸暂停综合征患者通过无创正压通气治疗的效果显著,可显著改善患者动脉血气指标,可促进患者肺功能恢复正常活动,显著提高睡眠质量,缩短夜间睡眠呼吸暂停时间及次数,安全性高,值得推广。

Objective To investigate effect of noninvasive positive pressure ventilation on chronic obstructive pulmonary disease(COPD).Methods The paper chose 86 cases COPD patients complicated with sleep apnea syndrome from March 2017 to March 2018,and divided them into two groups according to admission order,control group and observation group.43 cases in control group were treated with routine drugs,and 43 cases in observation group with noninvasive positive pressure ventilation.Curative effect,pulmonary function index,arterial blood gas index,sleep quality,polysomnography monitoring index and adverse reactions incidence was compared between two groups before and after treatment.Results Effective rate of observation group 95.35%was higher than 81.39%of control group(P<0.05).After treatment,levels of pulmonary function index of FEV_(1),FVC,FEV_(1)/FVC,arterial blood gas index of pH,PaO_(2)and SpO_(2)Low in observation group were higher than control group,levels of PaCO_(2),longest apnea time and AHI in polysomnography monitoring index were lower than control group,(P<0.05).After treatment,PSQI scores and ESS scores of sleep quality in observation group were lower than control group(P<0.05).Incidence of adverse reactions in observation group was 9.30%,lower than 27.91%in control group(P<0.05).Conclusion Noninvasive positive pressure ventilation can achieve significant effect for COPD patients with sleep apnea syndrome,can improve arterial blood gas index,promote recovery of pulmonary function,improve sleep quality significantly,shorten time and times of sleep apnea at night,with high safety,which is worthy of promotion.