体外膈肌起搏治疗慢性阻塞性肺病呼吸衰竭的疗效

Effect of extracorporal diaphragmatic pacing onrespiratory fallure due to chronb obstrutive pulmonarydisease

报告体外隔肌起搏（ＥＤＰ）治疗慢性阻塞性肺病（ＣＯＰＤ）。结果：１１慢性肺心病重度Ⅱ型呼衰者应用ＥＤＰ后ＰａＯ＿２无明显提高（Ｐ＞０．４），ＰａＣＯ＿２明显降低（Ｐ＜０．０５）。２６例肺心病轻度Ⅱ型呼衰者应用ＥＤＰ后ＰａＯ＿２明显升高（Ｐ＜０．００１），ＰａＣＯ＿２明显降低（Ｐ＜０．００１）。１５例肺心病Ⅱ型呼衰者应用ＥＤＰ加高频喷射通气（ＨＰＪＶ）后，ＰａＯ＿２明显升高，ＰａＣＯ＿２增高不显著（Ｐ＞０．０５）。３２例ＣＯＰＤ者应用ＥＤＰ治疗（３０ｍｉｎ／ｄ）３０天后，ＰａＯ＿２、ＰａＣＯ＿２、肺活量（ＶＣ），每分通气量（ＭＶ）和６分钟步行距离（６ＭＤ）明显改善。表明ＥＤＰ是ＣＯＰＤ的有效康复疗法，但对肺心病严重Ⅱ型呼衰患者无效。

Treatment of chronic obstructive pulmonarydisease.(COPD)with external diaphragm pacemaker(EDP) was reported.11 patients with severe type Ⅱrespiratory fallure due to chronic cor pulmonale whoreceived EDPpreqented that PaO_2was notsignificantlyincreased(P>0.4 )and PaCO_2significantly decreased(P<0.05).26 patients withmild type Ⅱ respiratory failure due to chronic corpulmonale show ed that PaO_2 was significantly in-ereased(P<0.001 )ar1d PaCO_2significantly decreascd(P<0.00l).15patients with tvpe Ⅱ respiratory failureduc to chtonic cot pulmonalc who received EDP andHFJV presented that PaO_2 was significantiy increased(P<0. 001 ) and PaCO_2not,significantly increased(P>0.05)32 patients with COPD had heen treatedwith EDP (30 minutes per day for 30 day).The resultshowed that PaO_2 PaCO_2,Ve,MVV,and 6MD weresignmcantly improved.It is indicated that EDP is aneffective rehabilitation treatment for COPD,but isineffective in treating the severe typeⅡrespiratoryfailure due to chronic cor pulmonale.