无创正压通气对慢性阻塞性肺疾病合并睡眠呼吸暂停综合征的治疗效应

目的观察无创正压通气（NPPV）在慢性阻塞性肺疾病（COPD）合并睡眠呼吸暂停综合征（SAS）所致Ⅱ型呼吸衰竭中的治疗价值。方法对比分析NPPV对COPD合并SAS与单纯COPD所致Ⅱ型呼吸衰竭的治疗效应。COPD合并SAS组21例,COPD组33例。观察NPPV治疗前,治疗2 h,治疗第2 d、第3 d、第5 d和出院前的动脉血气分析变化。结果在COPD合并SAS组在应用NPPV治疗后及出院时各时间点pH值显著改善（P〈0.05）,PaCO2显著下降（P〈0.05）,PaO2显著升高（P〈0.05）。在COPD组应用NPPV治疗后各时间点和出院前PaCO2均显著下降（P〈0.05）,pH值显著改善（P〈0.05）;PaO2在应用NPPV治疗第2 d、第3 d、第5 d和出院前显著升高（P〈0.05）。结论 NPPV对COPD合并SAS和COPD所致的Ⅱ型呼吸衰竭均有较好的治疗效果。

The efficacy of non-invasive positive pressure ventilation for patients with respiratory failure of chronic obstructive pulmonary disease combined with sleep apnea syndrome

Objective To observe the efficacy of non-invasive positive pressure ventilation（NPPV） for patients with type Ⅱ respiratory failure secondary to COPD overlapped sleep apnea syndrome（overlap syndrome）.Methods Retrospective contrastive analysis the effect of NPPV for patients with respiratory failure between AECOPD and overlap syndrome.The overlap syndrome group were 21 patients,the AECOPD group were 33 patients.To observe the change of arterial blood gas analysis pre-NPPV and after NPPV for 2 hours,the second day,the third day,the fifth day,and the day prior to discharge.Results Compared to pre-therapy with NPPV,in overlap syndrome group,PaCO2 decreased,pH and PaO2 raised significantly in every time point after NPPV（P〈0.05）.In AECOPD group,PaCO2 descended and pH increased significantly in every time point after NPPV（P〈0.05）,and PaO2 raised significantly on the second day with NPPV and afterward（P〈0.05）.Conclusion NPPV are effective both in overlap syndrome and AECOPD patients with type Ⅱ respiratory failure.