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目的探究慢性阻塞性肺疾病(COPD)伴肺动脉高压(PH)的临床治疗策略。方法选择天津医科大学总医院滨海医院2015年7月-2017年1月61例COPD合并PH患者为观察对象,随机分为对照组和观察组,对照组28例根据患者实际情况给予低流量吸氧、茶碱类或β_2受体激动剂以解痉平喘、抗生素抗感染、化痰以及糖皮质激素等常规性治疗;观察组33例在此基础上进行无创通气。治疗1个月后,观察两组治疗前后血气分析、肺动脉压及状况。结果观察组治疗后PaO_2、PaCO_2、MPAP值均显著优于对照组,差异有统计学意义(P<0.05);观察组患者6min步行距离为(213.74±18.32)m,显著多于对照组的(147.43±19.17)m。结论无创正压通气与常规药物结合治疗是COPD合并PH的一种有效治疗手段,能够显著改善低氧血症,减少二氧化碳潴留,降低肺动脉压。
Objective To investigate the clinical treatment of chronic obstructive pulmonary disease (COPD) with pulmonary hypertension (PH). METHODS: Totally 61 COPD patients with PH were randomly divided into control group and observation group. 28 patients in control group were given low-flow oxygen inhalation , Theophylline or β_2 receptor agonist with antispasmodic and antiasthmatic, anti-infective antibiotics, phlegm and glucocorticoid and other routine treatment; observation group of 33 patients on the basis of this non-invasive ventilation. One month after treatment, blood gas analysis, pulmonary arterial pressure and status were observed before and after treatment. Results The PaO 2, PaCO 2 and MPAP values of the observation group were significantly better than those of the control group after treatment (P <0.05), and the distance between the observation group and the control group was (213.74 ± 18.32) m, significantly higher than that of the control group 147.43 ± 19.17) m. Conclusion Noninvasive positive pressure ventilation combined with conventional drugs is an effective treatment for COPD combined with PH, can significantly improve hypoxemia, reduce carbon dioxide retention and reduce pulmonary arterial pressure.