家庭无创通气对慢性阻塞性肺疾病稳定期并肺心病患者右心功能的影响

目的研究慢性阻塞性肺疾病（COPD）稳定期并肺心病患者在家庭使用无创通气治疗后右心功能的变化。方法将41例COPD稳定期并肺心病患者分为治疗组及对照组。治疗组20例使用无创双水平正压通气治疗，每日无创通气治疗4—7h，治疗间期给予低流量吸氧，无创通气加上低流量吸氧时间共15h以上。对照组21例给予长期家庭氧疗，每日低流量吸氧15h以上。结果治疗组治疗3个月后，肺动脉压（54．2±2．75mmHg）与对照组（59．9±1．76mmHg）比较差异有统计学意义（P〈0．01），右室Tei指数（0．74±0．02）与对照组（O．80±O．04）比较差异有统计学意义（P〈0．01）。结论家庭无创正压通气能有效的改善COPD稳定期并肺心病患者右心功能，值得进一步研究。

Influence of Home Noninvasive Ventilation on Right Heart Function for Chronic Obstructive Pulmonary Disease at Stable Stage with Pulmonary Heart Disease Patients

Objective To study the change of home noninvasive ventilation for chronic obstructive pulmonary disease（COPD） at stable stage with pulmonary heart disease patients on right heart function. Methods Forty one cases of COPD patients at stable stage with pulmonary heart disease patients were selected and divided into two groups ,with 20 cases in the test group received noninvasive double lev- el ventilation, noninvasive ventilation treatment 4 - 7 hour and low flow inhale oxygen, total time over 15 hours everyday;21 cases in the control group received long- term home oxygen therapy,low flow inhale oxygen over 15 hours everyday. Results After three months of treatment, the pulmonary arterial pressure of the test group and control group were（ 54.2 ± 2.75 ） mmHg and（ 59.9 ±1.76） mmHg, and the diference between the two groups was statistically significant（P 〈 0.01 ）. Right ventricular Tei index of the test group and control group were （ 0.74 ± 0.02 ） and （0.80 ± 0.04 ） , and the diference between the two groups was statistically significant （ P 〈 0.01 ）. Conclusion Home noninvasive positive pressure ventilation has obvious efect on the right heart function improvement of COPD at stable stage with pulmonary heart disease patients, and it worth further research.