BiPAP治疗重度慢性阻塞性肺疾病并OSAHS的临床分析

Clinical analysis on BiPAP in treatment of severe chronic obstructive pulmonary disease with obstructive sleep apnea hypoventilation syndromes

目的探讨不同时段BiPAP治疗重度慢性阻塞性肺疾病患者重叠综合征的临床效果。方法 67例重叠综合征患者按BiPAP通气时段不同分为昼治疗组(21例)、夜治疗组(23例)及综合治疗组(23例)。3组患者均采取常规治疗措施,在此基础上,昼治疗组BiPAP时段为8:00—12:00及14:00—18:00共8 h,夜治疗组BiPAP时段为22:00—次日6:00共8 h,综合治疗组BiPAP时段为以上2组所有时段共16 h。对比入院时、治疗72 h后及7 d后患者的动脉血气分析指标(pH、p(O2)、p(CO2))及呼吸暂停低通气指数(AHI),比较3组住院时间。结果在72 h后及7 d后2组血气指标及PSG指标除pH值外均显著改善(P均<0.05)。综合治疗组住院时间与其他组比较显著缩短(P<0.05)。结论昼夜均进行BiPAP更有利于重叠综合征的治疗。

Objective It is to approach the clinical effect of BiPAP in different kind of ventilation time interval on overlap syndrome （OS）. Methods 67 patients with OS were randomly divided into daytime group （21 cases） , night group （23 cases） and complex group （23 cases） according to the different ventilation time interval of BiPAP. Three group of patients besides were accepted the convention remedial measure according to the guide, the BiPAP time interval was 8 to 12 o＇ clock and 14 to 18 o＇ clock altogether 8 hours in daytime group, 22 o＇ clock to the next day 6 o＇ clock altogether 8 hours in night group, combined above two group of all time interval altogether 16 hours in complex group. At the time of start, 72 hours and 7 days after treatemtn, the indexes as artery courage vigor analysis （pH, p（ 02 ） , p（CO2） ） and apnea low ventilation index （AHI） were compared. The of three groups were observed and compared. Results Excepted pH, the indexes as vigor analysis and Polysomnogram （PSG） at the time of 72 hours and 7 days after treatment were markedly improved, the hospital stays of complex group were markedly shortened than the others （ all P 〈 0.05 ）. Conclusion BiPAP both in day and night is more advantageous to treat OS.