无创通气在COPD合并肺癌患者中的应用

Application of noninvasive ventilation in patients with COPD complicated with lung cancer

目的探讨无创通气在慢性阻塞性肺疾病(COPD)合并肺癌患者中的应用及对肺功能的影响。方法选取2017年5月至2018年6月间上海健康医学院附属嘉定区中心医院收治的82例COPD合并肺癌患者,根据治疗方法不同分为观察组和对照组,每组41例。对照组患者采用常规对症治疗,观察组患者在对照组基础上联合无创通气治疗,治疗1个月后,比较两组患者临床疗效、血气水平、肺功能水平及肺气肿Goddard评分。结果治疗后1个月,观察组患者p H和动脉血氧分压水平均高于对照组,二氧化碳分压水平低于对照组,差异均有统计学意义(均P <0. 05)。治疗后1个月,观察组患者肺功能PEF1、PEF、FVC及PEF25%~75%水平均高于对照组,差异均有统计学意义(均P <0. 05)。治疗后1周、2周、3周及4周,两组患者肺气肿Goddard评分均低于治疗前,且观察组各时间评分均低于对照组,差异均有统计学意义(均P <0. 05)。结论 COPD合并肺癌患者采用无创通气治疗,能改善患者血气水平,提高肺功能,改善肺气肿Goddard评分,值得推广应用。

Objective To investigate the application of non-invasive ventilation in patients with chronic obstructive pulmonary disease(COPD)complicated with lung cancer and its effect on pulmonary function.Methods From May 2017 to June 2018,82 patients with COPD complicated with lung cancer were divided into an observation group and a control group with 41 patients in each group.The observation group was given conventional symptomatic treatment combined with non-invasive ventilation.The control group received conventional symptomatic treatment.At ne month after the treatment,the treatment efficacy,blood gas level,lung function level and Goddard score for emphysema were compared between the two groups.Results The pH and arterial oxygen partial pressure levels were higher in the observation group than in the control group at 1 month after treatment(all P<0.05).The carbon dioxide partial pressure level was lower in the observation group than in the control group(P<0.05).Forced expiratory volume in one second(FEV1),peak expiratory flow(PEF),forced vital capacity(FVC),and PEF 25%to75%were higher in the observation group than in the control group at 1 month after the treatment(all P<0.05).The Goddard score for emphysema was lower in both groups at 1,2,3 and 4 weeks after the treatment than that before the treatment with the score lower in observation group than in the control group(P<0.05).Conclusion Non-invasive ventilation can improve blood gas levels,lung function and the Goddard score for emphysema in patients with COPD complicated with lung cancer.It is worthy of popularization and application.