无创正压通气治疗COPD合并OSAHS临床疗效及对睡眠质量影响

Non-invasive Positive Pressure Ventilation in the Treatment of COPD Combined with OSAHS and Its Effect on Sleep Quality

目的:探讨无创正压通气治疗慢性阻塞性肺疾病(COPD)合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)临床疗效及对睡眠质量影响.方法:选取2017年8月至2019年3月北京大学第三医院延庆医院收治的COPD合并OSAHS患者120例作为研究对象,按照随机数字表法分为对照组和观察组,每组60例.对照组给与常规解痉、平喘、抑制炎性反应等基础治疗,观察组给与无创正压通气联合基础治疗,比较2组患者疗效及治疗前后氧分压(PaO2)、二氧化碳分压(PaCO2)水平及睡眠质量.结果:观察组患者治疗总有效率(96.67%)显著高于对照组(86.67%),差异有统计学意义(P<0.05).治疗前,对照组和观察组PaO2 、PaCO2 水平比较,差异无统计学意义(P>0.05);治疗7 d,相对治疗前,2组患者PaO2 水平升高,PaCO2 水平降低,但观察组患者改善程度更显著,差异有统计学意义(P<0.05).治疗前,对照组和观察组睡眠质量评分比较,差异无统计学意义(P>0.05);治疗7 d,相对治疗前,2组睡眠质量评分均下降,但观察组患者睡眠质量评分显著低于对照组,差异有统计学意义(P<0.05).结论:无创正压通气治疗COPD合并OSAHS能改善患者血气水平,提高临床疗效及患者睡眠质量.

Objective:To investigate the clinical efficacy and non-invasive positive pressure ventilation in the treatment of chronic obstructive pulmonary disease(COPD)with obstructive sleep apnea hypopnea syndrome(OSAHS)and its impact on sleep quality.Methods:A total of 100 case of COPD merges with OSAHS patients in our hospital during August 2017 to March 2019 were enrolled as studying object,and divided into the control group and observation group,with 60 cases in each group.The control group was given conventional antispasmodic,antiasthmatic,anti-inflammatory response and other basic treatments,while the observation group was given noninvasive positive pressure ventilation combined with basic treatment.The efficacy of the two groups of patients and the partial pressure of oxygen(PaO 2),partial pressure of carbon dioxide(PaCO 2)and sleep quality before and after treatment were compared.Results:The total effective rate of treatment in the observation group(96.67%)was significantly higher than that in the control group(86.67%)(P<0.05).Before treatment,there was no significant difference in PaO 2 and PaCO 2 levels between the two groups(P>0.05).Before treatment,the PaO 2 level was increased and the PaCO 2 level was decreased in the two groups before treatment.However,the improvement of the observation group was more significant(P<0.05).Before treatment,there was no significant difference in sleep quality score between the control group and the observation group(P>0.05).After 7 days of treatment,the sleep quality scores of the two groups were decreased before the treatment,but the sleep quality score of the observation group was significantly lower than that of the control group(P<0.05).Conclusion:Noninvasive positive pressure ventilation in the treatment of COPD combined with OSAHS can improve blood gas levels,improve clinical efficacy and sleep quality.