昼夜使用BIPAP治疗慢性阻塞性肺疾病的效果对比

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摘要目的比较昼夜使用BIPAP治疗慢性阻塞性肺疾病（COPD）的效果。方法随机选取2014年7月～2016年5月我院收治的50例COPD急性发作患者作为研究对象，根据无创辅助通气时间分为日间组（33例）和夜间组（17例）。比较两组治疗前和治疗后2 h的动脉血气分析数据（PaCO2、PaO2、pH）、呼气峰值流速（PEF）、氧合指数、呼吸频率、心率、血压。结果两组治疗后的PEF水平高于治疗前，PCO2水平低于治疗前，差异有统计学意义（P＜0.01）。夜间组治疗后的PO2水平显著高于治疗前，日间组治疗后的pH值显著高于治疗前，差异有统计学意义（P＜0.01）。两组治疗前与治疗2 h后的氧合指数、呼吸频率、心率、血压比较，差异无统计学意义（P＞0.05）。与夜间组相比，日间组PCO2降低更明显；与日间组比较，夜间组PO2升高更明显，差异有统计学意义（P＜0.01）。结论不同时段无创辅助通气治疗对COPD急性发作患者的效果不同，临床医生可根据患者情况选择不同的时段进行无创辅助通气治疗。

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	胡崇静
	卢树标
	谭卓华
	黄小艳

关键词 ：慢性阻塞性肺疾病, BIPAP, 日间, 夜间

Abstract：Objective To compare the effect of biphasic intermittent positive airway pressure (BIPAP)at daytime and nighttime in the treatment of chronic obstructive pulmonary diseases(COPD).Methods Altogether 50 cases of acute exacerbation of COPD who were treated in our hospital from July 2014 to May 2016 were randomly selected as the object of this research,and were divided into the daytime group(n=33)and the nighttime group(n=17)according to the time of noninvasive assisted ventilation.The arterial blood gas analysis data (PaCO2,PaO2,PH),peak expiratory flow(PEF)，oxygenation index(OI),respiratory rate(RR),heart rate(HR),blood pressure of the two groups at pre-and post-treatment 2 hours were compared.Results The level of PEF in the two groups after treatment was higher than that before treatment,and the level of PCO2in the two groups after treatment was lower than that before treatment,with significant difference (P＜0.01).The level of PO2in the nighttime group after treatment was higher than that before treatment,and the pH value of the daytime group after treatment was higher than that before treatment,with significant difference (P＜0.01).There was no significant difference between the level of OI,RR,HR and blood pressure of the two groups before and two hours after treatment(P＞0.05).Compared with the nighttime group,the level of PCO2in the daytime group decreased more significantly;compared with the daytime group,the level of PO2in the nighttime group increased significantly,with significant difference(P＜0.01).Conclusion Noninvasive assisted ventilation in different time of the day plays different effect on patients with AECOPD.Clinicians can carry out noninvasive assisted ventilation in different time of the day according to the patient′s conditions.

Key words： Chronic obstructive pulmonary disease Biphasic intermittent positive airway pressure;Daytime Nighttime

基金资助:广东省佛山市顺德区医学科学技术研究计划项目（2014004）

引用本文:

胡崇静;卢树标;谭卓华;黄小艳. 昼夜使用BIPAP治疗慢性阻塞性肺疾病的效果对比[J]. 中国当代医药, 2017, 24(4): 35-38.
HU Chong-jing;LU Shu-biao;TAN Zhuo-hua;HUANG Xiao-yan. Comparison of the application effect of BIPAP at daytime and nighttime in the treatment of chronic obstructive pulmonary diseases. 中国当代医药, 2017, 24(4): 35-38.

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[1]	Vaudan S，Ratano D，Beuret P，et al.Impact of a dedicated noninvasive ventilation team on intubation and mortality rates in severe COPD exacerbations[J].Respir Care，2015，60（10）：1404-1408.
[2]	Yan HY，Yang Y，Wu YL.Clinical analysis of optimal timing for application of noninvasive positive pressure ventilation in treatment of AECOPD patients[J].Eur Rev Med Pharmacol Sci，2014，18（15）：2176-2181.
[3]	汪明星.无创面罩双水平正压通气治疗慢性阻塞性肺疾病急性加重合并呼吸衰竭的临床效果观察[J].中国当代医药，2015，23（28）：27-29.
[4]	周瑛，张有志，常晶，等.慢性阻塞性肺疾病患者病情加重与昼夜节律的相关性[J].临床肺科杂志，2015，20（6）：1056-1058.
[5]	刘辉国，徐永健.慢性阻塞性肺疾病睡眠低氧现状与诊治进展[J].中国实用内科杂志，2010，30（4）：300-303.
[6]	裴翀，丁震，李秀.慢性阻塞性肺病夜间低氧血症的发生及相关预测因素[J].临床肺科杂志，2011，16（8）：1240-1242.
[7]	Greenberg-Dotan S，Reuveni H，Tal A，et al.Increased prevalence of obstructive lung disease in patients with obstructive sleep apnea[J].Sleep Breath，2014，18（1）：69-75.
[8]	US National Institutes of Health.Global initiative for asthma：global strategy for asthma management and prevention[J]. Bethesda：NIH Publication，1995：3659.
[9]	Emermen CL，Cydulka PK.Use of peak expiratory flow rate in emergency department evaluation of exacerbation of chronic obstructive pulmonary disease[J].Ann Emerg Med，1996，27（2）：159-163.
[10]	滕翠丽，高艳，张锦，等.呼气峰流速与COPD气流阻塞判定指标的相关性研究[J].宁夏医学杂志，2013，35（8）：703-705.
[11]	Si XB，Zhang S，Huo LY，et al.Statin therapy does not improve lung function in asthma：a meta-analysis of randomized controlled trials[J].J Int Med Res，2013，41（2）：276-283.
[12]	杜秀芳，黄平，洪永忠，等.睡眠对慢性阻塞性肺疾病患者上气道阻力的影响[J].国际呼吸杂志，2011，31（3）：351-354.
[13]	Park M，Lorenzi FG，Feltrim MI，et al.Oxygen therapy，comtinuous positive ventilation in the treatment of acute cardiogenie pulmonary edema[J].Arq Bras Cardiol，2001，76（3）：221-230.
[14]	Ye M，Jia P，Wang X，et al.Clinical efficacies of bilevel positive airway pressure ventilator treatment in uremic patients with acuteheart failure[J].Zhonghua Yi Xue Za Zhi，2014，94（18）：1419-1421.
[15]	Casanova C，CeHi BR，Tost L，et al.Long-term controlled trial of noctumal nasal postive pressure ventilation in patients with severe COPD[J].Chest，2000，118（6）：1582-1590.
[16]	Chiang LL，Yu CT，Liu CY，et al.Six-month nocturnal nasal postive pressure ventilation improves respiratory muscle capacity and exercise endurance in patients with chronic hypercapnic respiratory failure[J].J Fomos Med Assoc，2006，105（6）：459-467.
[17]	崔朝勃，李煜，田振甲，等.夜间无创通气在COPD缓解期的康复治疗研究[J].临床肺科杂志，2000，5（3）：186-187.
[18]	Sin DD，Wong E，Mayers I，et al.Effects of nocturnal noninvasive mechanical ventilation on heart rate variability of patients with advanced COPD[J].Chest，2007，131（1）：156-163.
[19]	陈学远，刘维群，龙学明，等.夜间无创正压通气对COPD患者肺功能及生活质量的影响[J].临床肺科杂志，2008，13（6）：772-773.
[20]	Mc Evoy RD，Pierce RJ，Hillman D，et al.Noctumal noninvasive nasal ventilation in stable hypercapnic COPD：a randomized controlled trial[J].Thorax，2009，64（7）：561-566.
[21]	Duiverman ML，Wempe JB，Bladder G，et al.Two-year homebased nocturnal noninvasive ventilation added to rehabilitation in chronic obstructive pulmonary disease patients：a randomized controlled trial[J].Respir Res，2011，12：112.