贵州医科大学学报

2016, v.41;No.194(11) 1343-1346

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两种机械通气对COPD肺动脉高压伴发呼吸衰竭老年患者的疗效及BNP水平的影响
The Curative Effect of Mechanical Ventilation on Elder Patients with Pulmonary Arterial Hypertension Associated with Respiratory Failure and Influence on BNP Level

雷怀定;刘玉全;尤辉;
LEI Huaiding;LIU Yuquan;YOU Hui;Department of Respiratory,Affiliated Taihe Hospital of Hubei Medical College;

摘要(Abstract):

目的:探讨两种机械通气模式对慢性阻塞性肺疾病(COPD)肺动脉高压伴发呼吸衰竭老年患者的疗效及脑钠肽(BNP)水平的影响。方法:接受机械通气治疗的COPD肺动脉高压伴发呼吸衰竭的老年患者56例,随机均分成有创机械通气组(气管插管或气管切开行呼吸机实施辅助呼吸)和无创机械通气组(面罩呼吸机实施辅助呼吸)两组,比较治疗前和治疗24 h后两组患者p H值、动脉血氧分压(PaO_2)、动脉血二氧化碳分压(PaCO_2)及肺动脉压力,同时测定血浆BNP水平。结果:治疗前,两组患者p H值、PaO_2、PaCO_2、肺动脉压及血浆BNP水平比较,差异无统计学意义(P>0.05);两组治疗24 h后p H值和PaO_2高于治疗前,PaCO_2、肺动脉压力及血浆BNP水平低于治疗前(P<0.05);治疗24 h后有创机械通气组6项指标与无创机械通气组比较,差异有统计学意义(P<0.05)。结论:有创机械通气治疗COPD肺动脉高压伴发呼吸衰竭的老年患者效果优于无创机械通气,有创机械通气治疗患者BNP水平降低更为明显。
Objective: To investigate the curative effect of mechanical ventilation on elder patients with pulmonary arterial hypertension associated with respiratory failure and influence on BNP level.Methods: 56 cases of elder patients with pulmonary arterial hypertension associated with respiratory failure received treatment of mechanical ventilation. Patients were randomly divided into two groups:invasive mechanical ventilation group(assisted respiration of trachea cannula or tracheotomy breathing machine) and non-invasive mechanical ventilation group(assisted respiration of mask ventilator). The general information,p H value,the changes of pulmonary arterial pressure,the levels of BNP and blood gas analysis between two groups before and after 24 h of treatment were compared. Results:There was no statistical difference concerning p H value,PaO_2,PaCO_2,pulmonary arterial pressure and BNP level between two groups(P > 0. 05). Compared to the condition before the treatment,the related indexes of p H value and PaO_2 in both groups were improved after 24 h of treatment,and PaCO_2,pulmonary arterial pressure and BNP level were lower than before treatment(P < 0. 05); the indexes of invasive mechanical ventilation group compared with that of non-invasive mechanical ventila-tion group were statistical significant( P < 0. 05). Conclusion: The effect in invasive mechanical ventilation group is better than that in non-invasive mechanical ventilation group,and the decrease of BNP level was obvious.

关键词(KeyWords): 通气机,机械;高血压,肺性;呼吸功能不全;疗效;脑钠肽
ventilators,mechanical;hypertension,pulmonary;respiratory insufficiency;curative efficacy;brain natriuretic peptide

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 雷怀定;刘玉全;尤辉;
LEI Huaiding;LIU Yuquan;YOU Hui;Department of Respiratory,Affiliated Taihe Hospital of Hubei Medical College;

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DOI: 10.19367/j.cnki.1000-2707.2016.11.025

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