医院家庭序贯无创通气治疗慢性阻塞性肺病并肺动脉高压患者的疗效评价

Evaluation of the efficacy of hospital family sequential noninvasive positive-pressure ventilation in treatment of chronic obstructive pulmonary disease and pulmonary hypertension

目的探讨医院家庭序贯无创通气治疗慢性阻塞性肺疾病(慢阻肺)合并肺动脉高压患者的疗效;方法选择接受医院无创通气并携带家庭型Bi PAP呼吸机返家或坚持每日在无创通气中心进行无创通气治疗的症状较重(CAT评分≥10分)的慢阻肺并肺动脉高压患者30例作为序贯组,以同期同病情在住院期间接受无创通气,出院后因各种原因停用无创通气而改用氧疗的症状较重的慢阻肺(CAT评分≥10分)并肺动脉高压患者30例为对照组,两组患者接受无创通气或氧疗的时间为每天10 h,观察时间半年,两组的药物治疗基本相同。所有患者在住院期间行CAT评分,并行血气分析计算氧合指数及心脏彩超检查,测量患者肺动脉压及右心室内径,半年后两组患者再次行CAT评分,查血气分析计算氧合指数,心脏彩超检查以测量患者肺动脉压及右心室内径。结果序贯组治疗前后的CAT评分,氧合指数,肺动脉压及右心室内径,比较差异均有统计学意义,对照组治疗前后的CAT评分,氧合指数,肺动脉压及右心室内径比较差异均无统计学意义。结论医院家庭序贯无创通气用于治疗慢阻肺疾病合并肺动脉高压患者,可以改善其生活质量,提高氧合指数,降低肺动脉压力,缩小右心室内径,疗效肯定。

Objective To investigate the efficacy of the efficacy of hospital family sequential noninvasive positive-pressure ventilation in treatment of chronic obstructive pulmonary disease and pulmonary hypertension. Methods The sequential group constituted by 30 patients with severe symptoms （CAT score ≥ 10 points） with COPD and pulmonary hypertension who accepted noninvasive positive-pressure ventilation and families breathing ma- chine （BiPAP） or adhere to a daily noninvasive positive-pressure ventilation in the center of noninvasive ventilation therapy. The control group included 30 patients with severe symptoms （CAT score≥ 10 points） with COPD and pul- monary hypertension who accepted noninvasive positive-pressure ventilation and had oxygen therapy after leaving hos- pital. The two groups received 10 hours＇ treatment per day, for half a year. All patients were given CAT score, blood gas analysis, parallel computing oxygenation index and echocardiography to measure pulmonary artery pressure and right ventricular diameter during hospitalization, and did it all again half a year later. Results There were signifi- cant differences in CAT scores, oxygenation index, pulmonary artery pressure, and right ventricular diameter in the observation group after treatment, but there was no significant difference in the control group. Conclusion The effi- cacy of the efficacy of hospital family sequential noninvasive positive-pressure ventilation in treatment of chronic ob- structive pulmonary disease and pulmonary hypertension is favorable, which can improve their quality of life and oxy- genation index, reduce pulmonary artery pressure and right ventricular diameter.