COPD合并急性心力衰竭患者使用BiPAP呼吸机联合常规药物的疗效

Efficacy of COPD patients with heart failure using BiPAP ventilator combined conventional drug therapy

目的：探讨BiP AP呼吸机联合常规药物在治疗慢性阻塞性肺疾病（COPD）合并急性心力衰竭患者中的应用价值。方法：回顾性分析我院于2010年9月~2013年8月收治的84例患有COPD合并急性心力衰竭患者的临床资料,根据治疗方式的不同将其分为试验组和对照组,其中对照组（n=40）给予常规药物治疗,试验组（n=44）在常规药物治疗的基础上给予使用BiP AP呼吸机辅助通气,对比分析两组患者治疗后的呼吸、心率、血压、脑钠肽以及血气分析等指标变化。结果：试验组使用BiP AP呼吸机通气后,临床胸闷气促症状较对照组改善明显,急性心力衰竭症状得到明显缓解,且无明显不耐受面罩等不良反应。两组患者的心率、呼吸频率、血气分析（PH、PaO 2、PaC O2）等指标比较差异显著,有统计学意义（P〈0.05）;从BNP水平来看,治疗1天后试验组的BNP水平明显低于对照组,组间比较差异有统计学意义（P〈0.05）。结论：COPD合并急性心力衰竭患者应用BiP AP呼吸机联合常规药物治疗效果显著,能显著改善患者的心衰症状,并且操作简单,安全性高,值得在临床上推广应用。

Objective： To evaluate the value of BiP AP joint conventional drug therapy in patients with acute heart failure and chronic obstructive pulmonary disease（COPD） in order to take reasonable choice for the treatment of clinical reference. Methods： 84 patients with COPD acute heart failure were selected and randomly divided into the observation group and the control group. The observation group（n=44） was given the use of BiP AP mechanical ventilation on the basis of conventional drug therapy. The control group（n=40）was treated with conventional therapy. The heart rate, blood pressure, brain natriuretic peptide and blood gas analysis and other indicators of change in two groups were recorded and compared. Results： the clinical symptoms of acute heart failure of the observation group improved better than that of the control group;the heart rate, respiratory rate, blood gas analysis（PH, PaO 2, PaC O2） and other indicators of the observation group improved better than these of the control group. The difference was statistically significant（P〈0.05）; the BNP level improved better than that of the control group one day after the treatment of BiP AP ventilator,The difference was statistically significant（P〈0.05）. Conclusion： COPD patients with acute heart failure combined the application of BiP AP ventilator and conventional drug treatment can achieve significant effect, symptoms of acute heart failure can be reliefed, and the operation of BiP AP ventilator is simple, safe.To sum up, BiP AP ventilator is worthy of clinical application.