双水平气道正压通气治疗重叠综合征后心肺功能及血气指标的变化研究

Effect of bi-level airway pressure ventilation on cardiopulmonary function and blood gas indexes in patients with overlap syndrome

目的探讨双水平气道正压通气(BiPAP)治疗重叠综合征(OS)后患者心肺功能及血气指标的改变及其对预后的影响,为临床OS治疗方案的合理制订提供依据。方法将内蒙古医科大学附属医院2014年9月至2016年8月收治的OS患者72例纳入研究,进行单中心随机对照试验,所有入选者以随机数字表法分为试验组与对照组,每组36例。两组研究对象均接受基础治疗,对照组选择持续正压通气(CPAP)治疗,试验组采用BiPAP治疗,连续治疗3d后对两组患者心肺功能及血气指标进行评价。同时应用自拟生活质量调查问卷及呼吸困难(MRC)评分工具就两组短期预后进行比较。结果试验组治疗后肺活量(FVC)、第1秒用力呼气容积占预计值的百分比(FEV1%)、最大通气百分比(MVV%)及FEV1/FVC%水平均较对照组显著升高,差异有统计学意义(P<0.05);HR、RR水平低于对照组,差异有统计学意义(P<0.05);血气指标比较中除血氧饱和度(SpO_2)外,其他参数值,如pH、血氧分压(PaO_2)、二氧化碳分压(PaCO_2)的比较,试验组均优于对照组(P<0.05);生活质量及MRC评分比较,试验组低于对照组,差异有统计学意义(P<0.05)。结论相比于CPAP的通气方式,选择BiPAP通气方式治疗OS,更有利于患者心肺功能及血气指标的恢复,从而为改善预后提供了保障。

Objective To evaluate the effect of bi-level airway pressure treatment(BiPAP)on heart,lung function and blood gas indexes in patients with overlap syndrome(OS)as well as its influence on prognosis,so as to provide the basis for clinical treatment.Methods A total of 72 cases with OS were selected in Inner Mongolia medical university affiliated hospital from September 2014 to August 2016.Patients included in the study were conducted a single-center randomized controlled trial,and according to random number table,all the cases were divided into experimental group and control group,36 cases in each group.Both groups accepted a basic treatment,and the control group treated with continuous positive airway pressure(CPAP)treatment,while the treatment group treated with BiPAP treatment.Two groups treated with continuous 3 dand after treatment,on cardiopulmonary function and blood gas indexes of two groups were evaluated.At the same time,quality of life questionnaire and MRC were applied to compare between two groups so as to evaluate the short-term prognosis.Results After treatment,trial forced vital capacity(FVC),percentage of forced expiratory volume in one second(FEV1%),percentage of maximum ventilation(MVV%)and FEV1/FVC%level were significantly higher than the control group(P<0.05).HR and RR were significantly lower than the control group(P<0.05).Except the SpO_2,other parameter values,such as pH,PaO_2,PaCO_2 of treatment group were better than control group(P<0.05).Quality of life and the MRC scores of treatment group were significantly lower than that of the control group(P<0.05).Conclusion Compared with CPAP ventilation way,BiPAP is more conducive to the recovery of patients with OS and is helpful to cardiopulmonary function and blood gas indexes,which provid guarantee to improve the prognosis.