【摘要】 目的探索无创正压机械通气(NPPV)长期家庭治疗重度慢性阻塞性肺疾病(COPD)稳定期患者的治疗作用。方法将40例经住院治疗处于稳定期的重度COPD患者,分为治疗组(常规治疗+NPPV)20例和对照组(常规治疗)20例。分别记录治疗前、治疗2年后的肺功能、动脉血气、6min行走距离(6MWO);病死率及每年住院次数等指标。结果治疗组与对照组的年龄、性别、身高、体重、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、用力肺活量(FVC)、第一秒用力呼气容积(FEV1)、6MWD、每年住院次数均具有可比性(t值分别为0.42、3.84、0.29、0.42、0.29、0.32、1.01、1.65、0.38、0.23,P均>0.05)。2年后治疗组死亡5例,对照组死亡8例,两组比较差异无统计学意义(χ2=3.84,P>0.05)。2年后治疗组PaO2、PaCO2、6MWD、每年住院次数与对照组比较差异均有统计学意义(t值分别为0.29、7.25、0.32、6.26、1.01、6.2、1.65、3.44、0.38、3.02、0.23、7.62,P均<0.05)。结论长期家庭无创正压机械通气对有选择性稳定期重度COPD患者治疗作用较为肯定。更多还原

【Abstract】 Objective To explore the treatment effect of long term home noninvasive positive pressure ventilation(NPPV)in stable severe patients with chronic obstructive pulmonary disease(COPD).Methods40 cases of in-hospital treatment severe COPD after stable period were divided into treatment group(conventional treatment+NPPV)and control group(conventional treatment),with 20 cases in each group.The lung function test,arterial blood gases,6MWD,mortality and hospitalization rates were recorded before the treatment and 2 years after the treatment.ResultsThe treatment group and control group of age,sex,height,weight,arterial PaO2 and PaCO2,forced vital capacity(FVC),forced expiratory volume in the first second(FEV1),6MWD,the number of in-patient per year were all comparable(t=0.42,3.84,0.29,0.42,0.29,0.32,1.01,1.65,0.38,0.23,P>0.05).5 cases in the treatment group and 8 cases in the control group were dead after 2 years,and the difference between the two groups was not significant(χ2=3.84,P>0.05).The measures of PaO2,PaCO2,6MWD,the number of in-patient per year between the groups were statistically significant difference(t=0.29,7.25,0.32,6.26,1.01,6.2,.65,3.44,0.38,3.02,0.23,7.62,P<0.05).ConclusionLong-term use of home noninvasive positive ventilation patients with stable severe COPD is effective and safe.更多还原