无创正压通气治疗慢性心肺功能衰竭继发高乳酸血症临床研究

The study of BiPAP in the treatment of patients with chronic cardiopulmonary failure and hyperlactacidemia

目的探讨无创正压通气与常规吸氧对慢性心肺功能衰竭继发高乳酸血症患者血乳酸水平及血气分析指标的影响。方法选取该院2014年5月至2016年5月收治慢性心肺功能衰竭继发高乳酸血症患者共100例,以随机数字表法分为对照组(50例)和观察组(50例),分别给予常规吸氧和无创正压通气治疗;比较两组患者治疗前后血乳酸水平、PaO2、PaCO2、pH、白细胞计数、N端前脑钠肽(NT-proBNP)、肌酐及清蛋白水平等。结果观察组患者治疗后血乳酸水平显著低于对照组、治疗前(P<0.05);观察组患者治疗后PaO2和PaCO2水平均显著优于对照组、治疗前(P<0.05);两组患者治疗后pH水平显著优于治疗前(P<0.05);但两组患者治疗后pH水平组间比较,差异无统计学意义(P>0.05);两组患者治疗后白细胞计数和肌酐水平均显著优于治疗前(P<0.05);两组患者治疗后白细胞计数和肌酐水平组间比较,差异无统计学意义(P>0.05);观察组患者治疗后NTproBNP水平显著低于对照组、治疗前(P<0.05);两组患者治疗前后清蛋白水平比较差异无统计学意义(P>0.05)。结论无创正压通气用于慢性心肺功能衰竭继发高乳酸血症患者可有效降低血乳酸浓度,改善血气分析指标,并有助于下调NT-proBNP水平,价值优于常规吸氧。

Objective To investigate the influence of BiPAP and conventional oxygen inhalation on blood lactic acid and blood gas analysis of patients with chronic cardiopulmonary failure and hyperlactacidemia.Methods 100 patients with chronic cardiopulmonary failure and hyperlactacidemia were chosen in the period from May 2014 to May 2016 in our hospital and randomly divided into both group including control group（50patients）with conventional oxygen inhalation and observation group（50patients）with BiPAP;and the levels of blood lactic acid,PaO_2,PaCO_2,pH,white blood cell count,NT-proBNP,creatinine and albumin before and after treatment of both groups were compared.Results The levels of blood lactic acid after treatment of observation group were significantly lower than control group and before treatment（P0.05）.The levels of PaO_2 and PaCO_2 after treatment of observation groups were significantly better than control group and before treatment（P0.05）.The levels of pH after treatment of both groups were significantly higher than before treatment（P0.05）.There was no significant difference in the levels of pH after treatment between 2groups（P0.05）.The levels of white blood cell count and creatinine after treatment of both groups were significantly higher than before treatment（P0.05）.There was no significant difference in the levels of white blood cell count and creatinine after treatment between 2groups（P0.05）.The levels of NT-proBNP after treatment of observation groups were significantly better than control group and before treatment（P0.05）.There was no significant difference in the levels of albumin before and after treatment between 2groups（P0.05）.Conclusion Compared with conventional oxygen inhalation,BiPAP in the treatment of patients with chronic cardiopulmonary failure and hyperlactacidemia can efficiently decrease the blood lactic acid concentration,improving the blood gas analysis index and be helpful to reduce the level of NT-proBNP.