序惯辅助控制通气对慢性肺心病合并呼吸衰竭患者心肺功能及全身炎症状态的影响

摘要

Objective:To study the influence of sequential auxiliary-control ventilation on chronic pulmonary heart disease complicated with respiratory failure patients cardiopulmonary function and inflammatory reaction.Methods:90 cases of chronic pulmonary heart disease complicated with respiratory failure patients in our hospital during May 2012 to February 2016 were randomly divided into observation group and control group,each group was formed by 45 cases.Patients in control group were treated with whole assist control ventilation (A/C),those in observation group were treated with A/C combined with BiPAP.Compared the difference in cardiopulmonary function,serum inflammatory factors between two groups.Results:Before treatment,there were no significant difference between two groups in the indices of cardiac function,arterial blood gas and inflammatory factors(P＞0.05).After treatment,two groups cardiac function indices such as PASP,RVd were lower than before treatment,level of EFRV was higher than that before treatment,and indices in observation group changed more significante compared with control group(P＜0.05);arterial blood gas indices PaO2 was higher compared with that before treatment,level of PaCO2 was lower compared with that before treatment,and those in observation group changed more significante compared with control group(P＜0.05);serum inflammatory cytokines hs-CRP,IL-6,TNF-α were lower compared with that before treatment,and those in observation group changed more significante compared with control group(P＜0.05).Conclusion:Sequential auxiliary control ventilation can improve cardiopulmonary function and reduce systemic inflammatory response in patients with chronic pulmonary heart disease complicated with respiratory failure.%目的:探讨序惯辅助-控制通气对慢性肺心病合并呼吸衰竭患者心肺功能及全身炎症状态的影响.方法:收集2012年5月～2016年2月间本院收治的慢性肺心病合并呼吸衰竭患者90例,按照随机数表法分为观察组、对照组各45例.对照组患者全程接受辅助-控制通气(A/C),观察组患者接受A/C+无创双水平压力通气(BiPAP).治疗前后对比两组患者的心肺功能及血清炎症因子含量差异.结果:治疗前,两组患者的心功能指标、动脉血气水平、炎症因子含量差异无统计学意义(P＞0.05).治疗后,两组心功能指标PASP、RVd的水平均低于治疗前,EFRV的水平高于治疗前,且观察组变化较对照组显著(P均＜0.05);两组动脉血气指标PaO2水平均较治疗前上升,PaCO2水平较治疗前下降,且观察组变化较对照组显著(P均＜0.05);两组血清炎症因子hs-CRP、IL-6、TNF-α的含量低于治疗前,且观察组变化较对照组显著(P均＜0.05).结论:序惯辅助-控制通气可优化慢性肺心病合并呼吸衰竭患者的心肺功能,降低全身炎症反应.