面罩机械通气治疗老年重叠综合征并发呼吸衰竭的研究

Treatment of respiratory failure secondary to overlap syndrome by bilevel positive airway pressure ventilation via nasal/mouth mask

目的 探讨经口 鼻面罩双水平气道正压通气 (BiPAP)对老年重叠综合征 (OS)并发呼吸衰竭患者的治疗作用。方法 2 0例 6 0岁以上OS并呼吸衰竭患者随机分成两组 ,试验组采用BiPAP治疗 +常规临床治疗 (药物治疗 +氧疗 +体疗 ) ,对照组仅采用常规临床治疗。比较入院时、治疗结束时患者的多导睡眠图仪 (PSG)、动脉血气 (pH、PaO2 、PaCO2 )、肺功能 (FEV1、FEV1 FVC和MVV)及两组间治疗费用、住院时间和并发症等的差别。结果 治疗后 ,两组患者的动脉血气 (pH、PaO2 、PaCO2 )、肺功能 (FEV1、FEV1 FVC和MVV)及试验组的PSG监测结果均有明显好转 ;两组的并发症发生率无明显差别 (0 10vs 1 10 ,P =0 2 77)。结论 BiPAP对老年OS并呼吸衰竭患者具有良好的治疗作用。

Objective To evaluate the clinical effect of bilevel positive airway pressure (BiPAP) ventilation via nasal/ mouth mask in elderly patients with respiratory failure secondary to the overlap syndrome(OS).Methods 20 patients were randomly submitted either to standard therapy (medicalion, oxygen and physical therapy) plus BiPAP or to standard therapy alone. Polysomnography(PSG), arterial blood gas analysis(pH, PaO 2, PaCO 2), lung function(FEV1, FEV1/FVC and MVV) before and after treatment in each group and the difference of time, cost and complication of treatment between two groups were comparatively analysed.Results After treatment, it showed a significant improvement on pH, PaO 2, PaCO 2, FEV1, FEV1/FVC and MVV in these two groups and PSG results in trial group,although there was no significant difference in complication between two groups.Conclusion BiPAP ventilation is effective in elderly OS patients with respiratory failure.