摘要
目的对患有慢性阻塞性肺疾病(COPD)合并睡眠呼吸暂停低通气综合征(SAHS)的患者进行无创通气治疗,探讨无创通气治疗在治疗慢性阻塞性肺疾病(COPD)合并睡眠呼吸暂停低通气综合征(SAHS)的临床应用意义。方法从2016年3月—2018年7月入住该院的COPD合并SAHS患者中随机抽取76例,所有患者均无心力衰竭、精神疾病等不适合参与研究的疾病,在治疗期间统一清淡营养饮食,休息和运动时间基本一致。行无创通气治疗,通气治疗时间和通氧浓度一致。1个月后测量患者治疗前后的呼吸暂停低通气指数(AHI)、肺功能(FEV1/FVC)、Epowrth嗜睡评估值(ESS值)、血氧饱和度最低值(LSaO2)、凝血因子指标、血小板计数值。结果治疗1个月后对比治疗前后的肺功能(FEV1/FVC)、血氧饱和度最低值(LSaO2),治疗前患者的FEV1/FVC为(103.6±23.34),治疗后患者的FEV1/FVC为(54.2±10.44)(t=-4.177);治疗前患者的LSaO2为(63.43±9.02)%,治疗后患者的LSaO2为(80.33±13.69)%(t=-4.687)。治疗后两项指标均要优于治疗前,患者的肺功能有所改善(P<0.05)。经过治疗后,76例患者中ESS值从(18.49±4.65)分降低到(11.34±3.44)分(t=-4.651),AHI从(51.72±8.38)次/h降低到(24.20±4.67)次/h(t=-4.487)。AHI值和ESS值的改变均差异有统计学意义(P<0.05),睡眠质量有所好转,白天嗜睡情况得到了明显的改善。治疗后的凝血因子Ⅱ活性值为(89±4),显著低于治疗前的(94±3)(t=-4.487,P<0.05)。血小板计数也明显降低:从治疗前的(359.22±27.16)×10^9/L降低到(236.27±41.4)×10^9/L(t=-6.381,P<0.05)。凝血因子Ⅴ有所降低,但差异无统计学意义(P>0.05)。结论无创通气在治疗慢阻肺合并睡眠呼吸暂停综合征时有较好的治疗效果,同时还可以改善患者的凝血系统情况,减少肺心病、肺动脉高压等并发症的发生几率。
Objective To treat non-invasive ventilation in patients with chronic obstructive pulmonary disease (COPD) complicated with sleep apnea hypopnea syndrome (SAHS), and to explore non-invasive ventilation in the treatment of chronic obstructive pulmonary disease (COPD) with sleep respiration clinical significance of suspending hypoventilation syndrome (SAHS). Methods From March 2016 to July 2018, 76 patients with COPD and SAHS who were admitted to our hospital were randomly selected. All patients had no heart failure, mental illness and other diseases that were not suitable for the study. Rest and exercise time were basically the same. Non-invasive ventilation treatment, ventilation treatment time and oxygen concentration were consistent. One month later, the apnea hypopnea index (AHI), lung function (FEV1/FVC), Epowrth sleepiness evaluation (ESS value), lowest oxygen saturation (LSaO2), clotting factor index, and platelet count value were measured before and after treatment. Results After one month of treatment, the lung function (FEV1/FVC) and the lowest oxygen saturation (LSaO2) were compared before and after treatment. The FEV1/FVC of the patients before treatment was (103.6±23.34). The FEV1/FVC of the patients after treatment was (54.2±10.44)(t=-4.177);the preoperative LsaO2 was (63.43±9.02)%, and the LSaO2 of the patient after treatment was (80.33±13.69)%, and the(t=-4.687). After treatment, both indicators were better than before treatment, and the patient's lung function improved(P<0.05). After treatment,the ESS value of 76 patients decreased from (18.49±4.65)points to(11.34±3.44)points,(t=-4.651), AHI decreased from (51.72±8.38)times/h to (24.20±4.67)times/h(t=-4.487). The changes in AHI and ESS were statistically significant (P<0.05), the quality of sleep improved, and daytime sleepiness improved significantly. The therapeutic factor II activity value after treatment was (89±4), which was significantly lower than(94±3)before treatment(t=-4.487, P<0.05). Platelet counts were also significantly redu
作者
龚燕茂
GONG Yan-mao(Department of Respiratory Medicine, Dehong People's Hospital, Dehong, Yunnan Province, 678400 China)
出处
《中外医疗》
2019年第24期59-61,共3页
China & Foreign Medical Treatment
关键词
无创通气
慢阻肺
睡眠呼吸暂停低通气综合征
治疗
Non-invasive ventilation
Chronic obstructive pulmonary disease
Sleep apnea hypopnea syndrome
Treatment
