无创呼吸机治疗慢性阻塞性肺疾病合并睡眠呼吸综合征的疗效

Efficacy of non-invasive ventilator in the treatment of chronic obstructive pulmonary disease complicated with sleep apnea syndrome

目的探讨无创呼吸机应用于慢性阻塞性肺疾病(COPD)合并睡眠呼吸综合征(OSASH)患者的疗效。方法选取本院呼吸内科收治的COPD合并OSASH患者60例作为观察组,选择同期治疗的60例COPD患者作为对照组,2组均采取无创呼吸机行机械通气,每日通气6~12 h,持续治疗2个月。结果观察组治疗前血氧饱和度(SaO_2)、血氧分压[p(O_2)]、二氧化碳分压[p(CO_2)]与血HCO_3^-低于对照组(P<0.05);2组治疗后SaO_2、p(O_2)、p H值均显著高于治疗前,p(CO_2)与血HCO_3^-均显著低于治疗前,差异均有统计学意义(P<0.05)。观察组治疗前FEV_1/FVC与FEV_1均显著低于对照组(P<0.05),治疗后2组FEV_1/FVC与FEV_1均高于治疗前(P<0.05),但2组治疗后FEV_1/FVC与FEV_1差异均无统计学意义(P>0.05)。观察组机械通气呼气压力及潮气量均高于对照组(P<0.05)。结论采用无创呼吸机治疗可显著改善COPD合并OSASH患者血气指标,提高肺功能与通气效果,改善阻塞症状。

Objective To explore application of non-invasive ventilator in the treatment of chronic obstructive pulmonary disease （COPD） complicated with sleep apnea syndrome. Methods A total of 60 patients with chronic obstructive pulmonary disease （COPD） combined with sleep breathing syndrome （OSASH） in the department of respiratory medicine of our hospital were selected as observation group, and another 60 COPD patients were selected as control group. Both groups were treated with non-invasive ventilator for mechanical ventilation, daily ventilation lasted for 6 to 12 hours, and continued for 2 months. Results Blood oxygen saturation （SaO 2）, partial pressure of oxygen[ p （O 2）], partial pressure of carbon dioxide[ p （CO 2）] and HCO 3 - before treatment in the experimental group were significantly lower than that in the control group （ P 〈0.05）. After treatment, SaO 2, p （O 2）, pH value were significantly higher, while p （CO 2）and HCO 3 - were significantly lower than treatment before, the differences were statistically significant （ P 〈0.05）. FEV 1/FVC and FEV 1 before treatment in the observation group were significantly lower than that in the control group （ P 〈0.05）, and were higher after treatment than treatment before （ P 〈0.05）, but there was no difference between the two groups after treatment （ P 〉0.05）. The expiration pressure of mechanical ventilation and tidal volume of the experimental group were higher than that in the control group （ P 〈0.05）. Conclusion Non-invasive ventilator can improve blood gas index of COPD patients with sleep breathing syndrome, enhance pulmonary function and ventilation effect, and improve obstructive syndrome