氨茶碱联合双水平气道正压通气治疗重症呼吸衰竭患者的效果

Effects of Aminophylline combined with Bi-level positive airway pressure ventilation in treatment of patients with severe respiratory failure

目的:观察氨茶碱联合双水平气道正压通气(BiPAP)治疗重症呼吸衰竭患者的效果。方法:选取2022年2月至2023年2月该院收治的100例重症呼吸衰竭患者进行前瞻性研究,按照随机数字表法将其分为对照组和研究组各50例。两组均给予常规治疗,在此基础上,对照组采用BiPAP治疗,研究组在对照组基础上联合氨茶碱治疗。比较两组治疗前后脑氧代谢指标[颈内静脉血氧饱和度(SjvO_(2))、动脉-静脉血氧含量差(Ca-vO_(2))、脑氧摄取率(CEO_(2))]水平、血气分析指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、酸碱度(pH)]水平、血清乳酸水平及不良反应发生率。结果:治疗后,两组SjvO_(2)、CEO_(2)水平均高于治疗前,且研究组高于对照组,两组Ca-vO_(2)水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);治疗后,两组PaO_(2)、pH水平均高于治疗前,且研究组高于对照组,两组PaCO_(2)水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);治疗12、24、36、48、72 h后,两组血清乳酸水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:氨茶碱联合BiPAP治疗重症呼吸衰竭患者可改善脑氧代谢指标和血气分析指标水平,以及降低血清乳酸水平的效果优于单纯BiPAP治疗效果。

Objective:To observe effects of Aminophylline combined with Bi-level positive airway pressure(BiPAP)in treatment of patients with severe respiratory failure.Methods:A prospective study was conducted on 100 patients with severe respiratory failure admitted to this hospital from February 2022 to February 2023.They were divided into control group and study group according to the random number table method,50 cases in each.Both groups were given routine treatment.On this basis,the control group was treated with BiPAP,while the study group was treated with Aminophylline on the basis of that of the control group.The levels of cerebral oxygen metabolism indexes[internal jugular venous oxygen saturation(SjvO_(2)),arterial-venous oxygen content difference(Ca-vO_(2)),cerebral oxygen uptake rate(CEO_(2))],the blood gas analysis indexes[arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),pH]levels,the serum lactic acid level,and the incidence of adverse reactions were compared between the two groups before and after the treatment.Results:After the treatment,the levels of SjvO_(2)and CEO_(2)in the two groups were higher than those before the treatment,and those in the study group were higher than those in the control group;the levels of Ca-vO_(2)in the two groups were lower than those before the treatment,and those in the study group were lower than those in the control group;and the differences were statistically significant(P<0.05).After the treatment,the levels of PaO_(2)and pH in the two groups were higher than those before the treatment,and those in the study group were higher than those in the control group;the PaCO_(2)levels of the two groups were lower than those before the treatment,and that in the study group was lower than that in the control group;and the differences were statistically significant(P<0.05).After 12,24,36,48 and 72 h of treatment,the serum lactic acid levels of the two groups were lower than those before the treatment,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Aminophylline combined with BiPAP in the treatment of the patients with severe respiratory failure can improve the levels of cerebral oxygen metabolism indexes and blood gas analysis indexes and reduce the levels of serum lactic acid.Moreover,it is superior to single BiPAP treatment.