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目的:探讨无创双水平正压通气(BIPAP)应用于老年慢性阻塞性肺疾病伴左心衰竭患者中的效果。方法:回顾性分析绍兴市中心医院院2013年6月-2016年6月96例老年慢性阻塞性肺疾病伴左心衰竭患者临床诊治情况,其中以常规抗感染、祛痰、抗炎、支气管舒张剂及利尿、扩血管等治疗为对照组,48例;于常规治疗基础上实施无创双水平正压通气(BIPAP)治疗者为观察组,48例。记录两组患者治疗前、后收缩压、动脉血气分析、呼吸频率、心率及脑钠肽(BNP)等各项指标变化。统计两组患者呼吸困难缓解时间。结果:两组患者治疗后呼吸频率、收缩压、血氧饱和度及心率较治疗前显著改善,然除收缩压外,观察组患者其余各项指标改善程度均优于对照组,P<0.05。两组患者治疗后PaO2、PH、PaCO2及BNP水平较治疗前明显改善,而观察组pH及PaO2升高程度与PaCO2及BNP水平下降程度均明显优于对照组,P<0.05。观察组呼吸困难缓解时间为(21.96±4.58)min明显短于对照组(29.17±5.23)min,P<0.05。结论:应用BIPAP治疗老年慢性阻塞性肺疾病伴左心衰竭可显著改善患者临床症状,有利于促进患者康复。
Objective: To investigate the effect of noninvasive bi-level positive pressure ventilation (BIPAP) in senile patients with chronic obstructive pulmonary disease and left heart failure. Methods: A retrospective analysis of 96 cases of elderly patients with chronic obstructive pulmonary disease and left heart failure in Shaoxing Central Hospital from June 2013 to June 2016 was performed. The routine anti-infective, expectorant, anti-inflammatory and bronchodilator 48 cases were treated with BIPAP as the observation group on the basis of routine treatment. The control group was treated with diuretic and vasodilator. The changes of systolic blood pressure, arterial blood gas analysis, respiratory rate, heart rate and BNP were recorded before and after treatment in both groups. Statistics of two groups of patients with respiratory distress time. Results: After treatment, respiratory rate, systolic blood pressure, oxygen saturation and heart rate were significantly improved in both groups. However, except for systolic blood pressure, the improvement of other indicators in the observation group was better than that in the control group (P <0.05). The levels of PaO2, PH, PaCO2 and BNP in both groups were significantly improved after treatment, but the levels of PaO2 and PaO2 in the observation group were significantly lower than those in the control group (P <0.05). The relief time of breathlessness in observation group was (21.96 ± 4.58) min which was significantly shorter than that in control group (29.17 ± 5.23) min, P <0.05. Conclusion: BIPAP treatment of senile chronic obstructive pulmonary disease with left heart failure can significantly improve the clinical symptoms of patients, is conducive to promoting patient rehabilitation.