同步变压呼吸对慢性阻塞性肺疾病并Ⅱ型呼吸衰竭患者血流动力学的影响

Impact of synchronization transformer breathing treatment on hemodynamics of patients with COPD and Type II respiratory failure

目的探讨慢性阻塞性肺疾病（COPD）并Ⅱ型呼衰患者应用同步变压呼吸装置的血流动力学变化规律。方法选取42例住院期COPD并Ⅱ型呼衰患者，随机分为仰卧位呼吸、俯卧位呼吸、同步变压呼吸3组，每组14例，应用胸阻抗法无创血流动力学监测系统（BioZ．com）观察患者各阶段心指数（CI）、每搏输出量（SV）、心率（HR）、加速度指数（ACI）、胸腔液体容量（TFC）、体循环血管阻力指数（SVRI）、平均动脉压（MAP）等指标。结果3组患者的CI、SV、SVRI比较差异有统计学意义，同步变压呼吸组及仰卧位呼吸组的CI、SV比俯卧位呼吸组高（P〈0．05），而SVRI在同步变压呼吸组、仰卧位呼吸组均低于俯卧位呼吸组（P〈0．05）。结论俯卧位会对COPD并Ⅱ型呼衰患者的心脏泵血造成负担，而同步变压呼吸可能减轻患者心脏负荷，有利患者心肺功能恢复。

Objective To compare the Hemodynamics diversity of patients with COPD and Type II respiratory failure in synchronization transformer breathing treatment, and observe as well as explore the influence of circulatory system diversity law. Methods 42 inpatients with COPD and Type II respiratory failure were devided into 3 groups randomly： Supine position respiration, Prone position respiration and Synchronous transforming respiration, fourteen patients per group. The following circulatory parameters were monitored continuously through thoracic electrical bioimpedance （TEB） hemodynamic monitoring system （ Bioz. corn） ： cardiac index （ CI）, stroke volume （ SV ）, heart rate （ HR ）, acceleration index （ ACI ）, systemic vascular resistance index （SVRI）, mean arterial pressure （MAP） and thoracic fluid capacity （TFC）. Results Significant change of CI, SV and SVRI were obvered in the three group. Synchronous transforming respiration group and Supine position respiration group presented significant increase （P 〈 0.05） CI and SV, however, decrease SVRI （ P 〈 0. 05 ）, to that of Prone position respiration group. Conclusion Prone position respiration weaken heart function, in other way, the synchronization transformer respiration treatment may be prompts that this intervention may reduce cardiac burden of these COPD patients and do good to recovering cardio-pulmonary function.