高频通气并膈肌兴奋剂治疗肺心病Ⅱ型呼衰疗效评价

Effects of High Frequency jet Ventilation and Diaphragmatic Excitant on the Patients with Respiratory Failure TypeⅡ-Chronic Cor Pulmonale Disease

目的 :探讨在高频通气 (HFJV)治疗肺心病Ⅱ型呼衰并用膈肌兴奋剂咖啡因 ,氨茶碱对PaO2 及PaCO2 的影响 ,以评价临床应用价值。方法 :HFJV并用膈肌兴奋剂咖啡因 ,氨茶碱 (咖啡因组 )与以往治疗方法并用呼吸兴奋剂可拉明 (可拉明组 )静滴 ,分别为 32例与 2 6例进行治疗前及治疗后两小时血气分析对比。结果 :两组治疗后PaO2 均有显著提高 ,P值均 <0 .0 0 1。对PaCO2 影响 ,咖啡因组治疗后 ,PaCO2 由 (9.72± 1.4 6 )下降至 (7.6 4±1.2 2 )kPa,P <0 .0 5 ,有显著差异 ;可拉明组 ,治疗后PaCO2 由 (9.74± 1.6 2 )下降至 (8.92± 1.4 4 )kPa ,P >0 .0 5 ,虽有一定程度下降 ,但未有明显差异。结论 :HFJV并用膈肌兴奋剂治疗肺心病Ⅱ型呼衰 ,防止二氧化碳潴留 ,降低PaCO2 作用 ,比使用呼吸兴奋剂疗效肯定 。

Objective:To evaluate the therapeutic benefit of high frequency jet ventilation(HFJV)with diaphragmatic excitant caffeine and aminophylline on PaO 2 and PaCO 2 in the patients with respiratory failure of typeⅡ chronic cor pulmonale disease.Methods:Thirty two cases were treated with HFJV plus diaphragmatic excitant caffeine and aminophylline(caffeine group);26 cases were treated with HFJV plus coramine(coramine group). Blood gas analyse were determined before treatment and at two hours after treatment in all 58 cases. Results: It showed that PaO 2 were significantly increased after treatment in two groups(both P <0.001); for PaCO 2, which,in caffeine group,were descended from(9.72±1.46)kPa to(7.64±1.22)kPa after treatment( P < 0.05 ) while in coramine group were descended from(9.74±1.62)to (8.92±1.44)kPa( P > 0.05 ).Conclusion:Respiratory failure of typeⅡ chronic cor pulmonale disease is superior to that of respiratory center excitant in the prevention and treatment of CO 2 retention and reduction of PaCO 2. The results suggest that the therapy has clinical use value.