面(鼻)罩BiPAP通气联合可拉明治疗慢阻肺高碳酸血症的临床观察

Combination Therapy of BiPAP Ventilation Via facial(nasal) Mask with Coramine for Hypercapnia in Chronic Obstructive Pulmonary Disease

目的观察面(鼻)罩BiPAP通气联合可拉明治疗慢阻肺高碳酸血症的疗效。方法将90例慢阻肺高碳酸血症患者随机分为联合治疗组、BiPAP组、可拉明组。3组患者其它治疗均按临床常规进行,联合治疗组应用BiPAP通气每日4小时联合可拉明3.75g静脉滴注每日一次,BiPAP组应用BiPAP通气每日4小时,可拉明组应用可拉明3.75g静脉滴注每日一次,治疗7天后对3组治疗效果进行评价。结果联合治疗组能显著改善CO2潴留,治疗前后PaCO2差异显著(P<0.01);单用BiPAP通气对改善CO2潴留有统计学意义(P<0.05);单用可拉明对CO2潴留改善不明显(P>0.05)。临床疗效评价总有效率联合治疗组83.3%、BiPAP组60.0%、可拉明组33.3%。联合治疗组有效率与BiPAP组比较差异有统计学意义(P<0.05),与可拉明组比较差异显著(P<0.01)。结论面(鼻)罩BiPAP通气联合可拉明治疗慢阻肺高碳酸血症比两者单用较有效,值得临床推广。

Objective To observe the effects of combined Use of BiPAP （bileval positive airway pressure） Ventilation Via facial（nasal） mask with eoramine on the treatment of hypereapnia in chronic obstructive pulmonary disease（COPD）. Methods On the base of conventional treatment, 90 patients with hypercapic COPD were divided randomly into combination treatment group、 BiPAP group and coramine group. The combination treatment group was applied BiPAP ventilation via facial （nasal） mask 4 hours daily and coramine 3.75g iv drip daily for 7d, the BiPAP group was applied BiPAP ventilation 4 hours daily, and the coramine group was applied coramine 3.75g iv drip daily. Compare and evacuate the clinical effects in the three groups. Results The combination group showed very significant changes in decrease PaCO2（P〈0. 01）, while the BiPAP group showed significant changes（P〈0. 05） and the coramine group showed no significant changes（f〉0. 05）. The total effect rate in the combination group was 83. 3%, while the BiPAP group was 60. 0% and the coramine group was 33.3%. Compared the total effect rate in the combination group with the BiPAP group , significant difference was shown （P〈0. 05）; while compared with the coramine group, very significant difference was shown （P〈0. Ol）. Conclusion The effects of hypercapnia in COPD treated by combined use of BiPAP ventilation via facial （nasal） mask with coramine is better than that by only used BiPAP or coramine, such approach is worth spreading.