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目的探讨无创正压通气(NPPV)对慢性阻塞性肺病(COPD)合并Ⅱ型呼吸衰竭伴右心衰竭的治疗作用。方法选择COPD合并Ⅱ型呼吸衰竭伴右心衰竭57例,随机分为常规治疗组(27例)与常规治疗辅助NIPPV治疗组(30例),观察患者的心率、呼吸频率、血气分析指标及血浆NT-Pro-BNP水平。结果治疗后两组心率、呼吸频率呈下降趋势、血气分析指标呈好转趋势,NT-Pro-BNP水平呈下降趋势。结论 NIPPV可改善COPD合并Ⅱ型呼吸衰竭伴右心衰竭患者的酸中毒、增加氧合指数、减少PaCO2;NT-Pro-BNP在呼衰并右心衰竭患者的诊断及疗效评价尚待进一步研究。
Objective To investigate the therapeutic effect of noninvasive positive pressure ventilation (NPPV) on COPD with type Ⅱ respiratory failure and right heart failure. Methods Fifty-seven COPD patients with type Ⅱ respiratory failure and right heart failure were randomly divided into routine treatment group (n = 27) and routine adjuvant NIPPV treatment group (n = 30). The heart rate, respiratory rate, blood gas analysis and plasma NT-Pro-BNP levels. Results After treatment, the heart rate and respiratory rate of the two groups showed a decreasing trend. The indexes of blood gas analysis showed a trend of improvement, while the level of NT-Pro-BNP showed a decreasing trend. Conclusion NIPPV can improve acidosis, increase oxygenation index and decrease PaCO2 in COPD patients with type Ⅱ respiratory failure and right heart failure. The diagnosis and evaluation of NT-Pro-BNP in patients with respiratory failure and right heart failure are yet to be further studied.