摘要
目的 探讨肺心病失代偿期患者用BiPAP双相正压无创机械通气治疗后肺动脉压与肺功能的变化特点及其相关性。方法 对33例肺心病失代偿期心衰患者行无创BiPAP通气治疗2h, 分别在通气治疗前、后用脉冲多普勒探测肺动脉干中央血流, 测量加速度时间(AcT) 和右室射血时间(RVET), 计算AcT/RVET; 测量收缩期三尖瓣反流最大压差(TRPG)、计算肺动脉压(SPAP), 观测肺通气功能及血气分析等指标。结果 ( 1 ) BiPAP通气治疗前、后患者SPAP、AcT、AcT/RVET的均值间差别均有显著性意义(P<0. 001)。(2) 机械通气治疗前、后患者的FVC、PEF的均值间差别有显著性意义(P<0. 05), 而其他肺功能指标间差别均无显著性意义(P>0 .05)。(3) 机械通气治疗前、后患者动脉血氧分压(PaO2 )、动脉血氧饱和度(SaO2 ) 的均值间差别有显著性意义(P<0. 01), 而动脉血二氧化碳分压(PaCO2 ) 间差别无显著性意义(P>0. 05)。(4) 机械通气治疗后AcT与PaO2 呈正相关(r=0 .450,P<0 .001)。结论 BiPAP通气治疗后肺动脉压明显降低; 肺通气功能中流量-容量曲线呼气用力依赖部分的指标明显改变, 呼气用力非依赖部分的指标无改变, 动脉血气改变明显好转。BiPAP无创正压通气可明显降低肺心病失代偿期的肺动脉压, 且肺动脉压与肺功能之间呈同步改善。
Objective To study the changed characteri stics and the cor-relation characteristics of pulmonary artery pressure and pulm onary function in patients with corpulmonale(instable stage) by Bi-level positiv e airway pressure(BiPAP) ventilation,in order to guide the clinical treatment.Methods 33 patients with cor pulmonale(instable stage) were treated by noninvasive BiPAP 2 hours.Before and after,measuring Acceleration Ti me(AcT)and Right Ventricle Eject Time(RVET) at the pulmonary arterial trunk cent er flow,calculating the AcT/RVET.The Tricuspid valve Regurgitation Pressure Grad ientbiggest(TRPG) in the period of contracting time,the parameters of pulmonary function and blood-gas analysis.Results (1)Compared with the before ventilation the AcT was longer,SPAP was lower(P<0.05).(2) FVC,PEF were higher than before(P< 0.05).FEV 1,FEF 25%～75%,FEF75% were no difference than before(P>0.05).P aO 2,SaO 2% were higher than before(P<0.01).PaCO 2 was lower than befor e(P>0.05).(3) AcT was positively correlated with PaO 2(r=0.450,P =0.000).Conclusion (1)It is obvious that PAP decreased,parameters o f pulmonary function depend on forced expiratory changed,parameters of pulmonary function independ on forced expiratory unchanged,parameters of blood-gas analys is changed after ventilation.(2)It is obvious that PAP decreased of patients wit h cor pulmonale(instable stage) by BiPAP.There was obvious change at the same ti me between PAP and pulmonary function.
出处
《中国全科医学》
CAS
CSCD
2005年第10期796-798,共3页
Chinese General Practice
