不同时相应用无创呼吸机治疗慢性阻塞性肺疾病的临床分析

CLINICAL ANALYSIS OF NON——INVASIVEPOSITIVE PRESSURE VENTILATOR IN TREATMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE DURING DAY AND NIGHT

目的探讨不同时相应用(鼻)面罩双水平气道正压通气(BiPAP)对慢性阻塞性肺疾病(COPD)急性加重期患者的影响及相关因素分析。方法 COPD急性加重期患者53例随机分为二组,A组25例,平均年龄(56.26±6.38)岁,经综合治疗加白天应用BiPAP治疗4h;B组28例,平均年龄(60.31±8.62)岁,经综合治疗加夜间应用BiPAP治疗4h,治疗时间为1周。观察二组患者治疗前后肺功能,呼吸困难症状评分,C-反应蛋白,脑钠肽变化,并比较分析。结果二组治疗前,二组间肺功能,呼吸困难症状评分,C-反应蛋白,脑钠肽差异无统计学意义(P>0.05);治疗后二组间肺功能差异无统计学意义(P>0.05);C-反应蛋白,脑钠肽水平及呼吸困难症状评分,差异有统计学意义(P<0.05)。结论与白天比较,夜间应用BiPAP治疗慢性阻塞性肺疾病急性加重期患者能明显改善患者呼吸困难症状,降低血浆C-反应蛋白,脑钠肽水平。

Objective To investigate the clinical curative effect and relative analysis of the（nasal） mask bi-level positive airway pressure（BiPAP） ventilator in treatment of the severe chronic obstructive pulmonary disease（COPD） patients during day or night.Methods 53 COPD acute exacerbation patients were randomly studied as A group and B group.A group（n=25）,aged（56.26±6.38）years,were treated with combined modality therapy and BiPAP ventilator during day for 4 hours;B group（n=28）,aged（60.31±8.62）years,were treated with combined modality therapy and BiPAP ventilator during night for 4 hours,the total observation time was one week.Before and after treatment,lung function and dyspnea scorewere analyzed,the levels of C reactive protein and brain natriuretic peptide was detectied.Results Before treatment,there were no significant difference about lung function,dyspnea score,C reactive protein and brain natriuretic peptide（P〉0.05）;After treatment,there were significant difference about C reactive protein,brain natriuretic peptide and dyspnea score（P〈0.05）,but no significant difference about lung function（P〉0.05）.Conclusion Comparing with day in treatment of the severe chronic obstructive pulmonary disease patients,BiPAP ventilator in night can obviously ameliorate dyspnea,decrease levels of blood plasm C reactive protein and brain natriuretic peptide.