摘要
【目的】探讨无创双水平正压通气（BiPAP）联合呼吸兴奋剂治疗慢性阻塞性肺疾病（COPD）合并轻、中度肺性脑病的临床疗效及对炎症因子的影响。【方法】收集本院2013年12月至2015年12月收治的COPD合并轻、中度肺性脑病患者80例，随机分为观察组与对照组。两组患者均给予常规对症支持和BiPAP治疗，且观察组加用呼吸兴奋剂进行治疗。记录两组患者接受治疗前后各指标的变化情况。【结果】观察组治疗24h后动脉血氧分压（PaO2）水平高于对照组，二氧化碳分压（PaCO2）水平低于对照组（P〈O．05）；治疗后观察组患者血氧饱和度（SaO2）高于对照组，呼吸频率（RR）、心率（HR）低于对照组（均P〈0．05）；观察组患者白细胞介素6（IL-6）、白细胞介素8（IL-8）及白细胞介素10（IL-10）水平均显著低于对照组，其差异有统计学意义（均P〈0．05）；观察组通气时间、恢复意识时间、住院时间短于对照组（均P〈0．05），气管插管率均低于对照组（P〈0．05）；观察组治疗有效率为90．0％，明显高于对照组47．5％，其差异有统计学意义（P〈0．05）。【结论】应用BiPAP联合呼吸兴奋剂治疗COPD合并肺性脑病疗效佳，可有效减少气管插管率，缩短住院时间，值得临床推广应用。
[Objective]To investigate the changes of the inflammation factor levels and the clinical effect of noninva- sive bi-level positive airway pressure （BiPAP） combined with respiratory stimulant treatment on COPD patients with mild to moderate pulmonary encephalopathy. [MethodslA total of 80 patients with COPD and mild to moderate pulmonary en- cephalopathy at the Central Hospital of Jiangjin District between December 2013 and December 2015 were randomly divid- ed into the observation group （ n =40） and the control group （ n =40）. Patients in both groups received routine support- ive treatments in addition to BiPAP ventilation while the observation group was treated with respiratory stimulant. A vari- ety of the indicators （PaO2, PaCO2 ,SaO2, RR, HR） was recorded before and after treatment in two groups. [Results] After 24 hours of treatment, PaO2 and SaO2 in the observation group improved significantly more than those in the con- trol group （ P 〈0.05）. PaCO2, RR and HR were significantly lower in the observation group than in the control group, and aeration time, consciousness recovery time, hospital stay and tracheal intubation rate were significantly shorter （all P 〈0.05）. The levels of IL-6, IL-8 and IL-10 in the observation group were significantly lower than those in the control group （all P 〈0.05）.The effective rate of the observation group was 90.0%, which was higher than that of the control group （47.5 % ） ; it showed statistical significance （ P 〈0.05） . [Conclusion]Application of BiPAP combined with respir- atory stimulants is an effective treatment for COPD patients with pulmonary encephalopathy. It can reduce the tracheal in tubation rate and shorten the hospitalization time.
出处
《医学临床研究》
CAS
2017年第6期1061-1063,1068,共4页
Journal of Clinical Research
