【摘要】 目的 探讨双水平气道正压（BiPAP）通气对肺癌合并呼吸衰竭患者呼吸功能及气道炎症的影响。方法 依据治疗方式的不同将126例肺癌合并呼吸衰竭患者分为常规组（n=62，常规治疗）和BiPAP组（n=64，常规治疗+BiPAP通气）。比较BiPAP组患者治疗前后的呼吸力学指标[气道峰压（Ppeak）、气道阻力（RAW）、静态顺应性（Cst）]以及两组患者的炎症因子[白细胞介素（IL）-1β、IL-8、肿瘤坏死因子-α(TNF-α)及C反应蛋白（CRP）]水平、呼吸系统症状[改良呼吸困难量表（mMRC）及呼吸困难、咳嗽和痰量表（BCSS）]、并发症发生情况。结果 治疗后，BiPAP组患者的Ppeak、RAW均低于本组治疗前，Cst高于本组治疗前，差异均有统计学意义（P﹤0.05）。治疗后，两组患者IL-1β、IL-8、TNF-α、CRP均低于本组治疗前，BiPAP组患者IL-1β、IL-8、TNF-α、CRP水平均低于常规组，差异均有统计学意义（P﹤0.05）。治疗后，两组患者mMRC、BCSS评分均低于本组治疗前，且BiPAP组患者mMRC、BCSS评分均低于常规组，差异均有统计学意义（P﹤0.05）。两组患者的并发症总发生率比较，差异无统计学意义（P﹥0.05）。结论 BiPAP通气可提高肺癌合并呼吸衰竭患者的呼吸功能，减轻气道炎症，且不增加并发症发生风险。更多还原

【Abstract】 Objective To investigate the influence of bilevel positive airway pressure(BiPAP) ventilation on respiratory function and airway inflammation in lung cancer patients complicated with respiratory failure. Method According to different treatment methods, 126 patients with lung cancer complicated with respiratory failure were divided into conventional group(n=62, conventional treatment) and BiPAP group(n=64, conventional treatment + BiPAP ventilation).The respiratory mechanical parameters [peak airway pressure(Ppeak), airway resistance(RAW), static compliance(Cst)]in BiPAP group before and after treatment, and inflammatory cytokine [interleukin(IL)-1β, IL-8, tumor necrosis factor-α(TNF-α), C-reactive protein(CRP)] levels, respiratory symptoms [modified medical research council dyspnea scale(mMRC), breathlessness, cough, and sputum scale(BCSS)], and incidence of complications between the two groups were compared. Result After treatment, the Ppeak and RAW in BiPAP group were lower than those before treatment, and Cst was higher than that before treatment, the differences were statistically significant(P<0.05). After treatment, the levels of IL-1β, IL-8, TNF-α, and CRP in both groups were lower than those before treatment, the levels of IL-1β, IL-8, TNF-α,and CRP in BiPAP group were lower than those in conventional group, and the differences were statistically significant(P<0.05). After treatment, the mMRC and BCSS scores in both groups were lower than those before treatment, and the mMRC and BCSS scores in BiPAP group were lower than those in conventional group, and the differences were statistically significant(P<0.05). There was no statistically significant difference in the total incidence of complications between the two groups(P>0.05). Conclusion BiPAP ventilation can improve respiratory function and reduce airway inflammation in lung cancer patients complicated with respiratory failure, without increasing the risk of complications.更多还原