Tei指数评价双水平正压通气治疗COPD并发呼吸衰竭患者的右心功能

doi:10.3969/j.issn.10073205.2017.04.019

摘要/Abstract

摘要： 摘要］〓
〖HTH〗目的〖HTSS〗〖KG*2〗利用超声心动图Tei指数观察双水平正压通气治疗慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）并发呼吸衰竭患者右心功能的改善情况，探讨Tei指数对预测脱机是否有价值。
〖HTH〗方法〖HTSS〗〖KG*2〗选取COPD并发呼吸衰竭患者48例，入科后经口气管插管行机械通气，分别于入科第1天（上机前）、第2天和第5天行血气分析及床旁超声心动图检查，记录3个时点的心率（heart rate，HR）、呼吸频率（respiratory rate,RR）、酸碱度（pH）、氧分压（arterial partial pressure of oxygen，PO2）、二氧化碳分压（partial pressure of carbon dioxide,PCO2）、氧饱和度（saturation oxygen，SO2）、右心室前后径（right ventficular，RV）、右心室前壁厚度（right ventricular anterior wall thickness, RVAW）、肺动脉收缩压（pulmonary arterial systolic pressure,PASP）、右心室Tei指数，并行对比。根据入科第5天脱机是否成功，将患者分为脱机成功组（35例）和脱机失败组（13例），就2组患者3个时点的Tei指数进行比较。
〖HTH〗结果〖HTSS〗〖KG*2〗入科第2天和入科第5天所有患者的HR、RR、PCO2明显低于入科第1天，pH、PO2、SO2明显高于入科第1天，PASP、Tei指数明显低于入科第1天（P＜005）。3个时点所有患者RV、RVAW差异无统计学意义（P＞005）。随时间延长，2组患者Tei指数总体均呈下降趋势，脱机成功组下降的幅度更大，组间、时点间、组间·时点间交互作用差异均有统计学意义(P＜005)。
〖HTH〗结论〖HTSS〗〖KG*2〗对于COPD并发呼吸衰竭患者，采用双水平正压通气治疗可明显改善其症状及右心功能，提高治愈率；Tei指数是评价右心功能的较敏感指标，对预测脱机有一定价值。

关键词: 肺疾病, 慢性阻塞性, 呼吸功能不全, 呼吸, 人

Abstract: ［Abstract］ Objective〖HTSS〗〓To examine the improvement of Bilevel positive airway pressure（BiPAP) ventilation therapy on right ventricular function in chronic obstructive pulmonary disease（COPD） patients combined with respiratory failure by Tei index. To discuss if Tei index is valuable to predict the time for taking off ventilatior.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Fortyeight cases of COPD patients combined with respiratory failure were selected in ICU of our hospital, all of whom were given invasive mechanical ventilation with oral trachea cannula. Then the blood gas analysis and bedside echocardiography were examined in the first day(before BiPAP therapy), the second day and the fifth day after entering ICU. The heart rate(HR), respiratory rate(RR), power of hydrogen(PH), partial pressure of oxygen(PO2), partial pressure of carbon dioxide(PCO2), saturation oxygen(SO2), right ventricular diameter（RV), right ventricular anterior wall thickness（RVAW), pulmonary arterial systolic pressure（PASP) and right ventricular Tei index were recorded and compared among the three time spot. The patients were divided into two groups called successful takingoff group and failure takingoff group according to if they had been taken off ventilatiors or not in the fifth day. Tei index was compared between the two groups in the three different time spots.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓Compared with the indexes in the first day, the heart rate, respiratory rate and blood gas analysis of the patients were significantly improved and the PASP, right ventricular Tei index were significantly better in the second and fifth day(P＜005), and the difference was statistically significant. While the difference of RV and RVAW had no statistical significance. The difference of all the index between the second day and the fifth day had no statistical significance. With the time lapsing, The Tei index of the two groups was in a downward trend and the dates of the successful takingoff group declined by a large margin. The difference between groups,among time spots and among crossover effect of time and grouping factor had statistical significance.
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Invasive BiPAP ventilation can obviously improve the right ventricular function and cure rate in COPD patients combined with respiratory failure. Tei index is a sensitive index for evaluating right heart function and may be valuable to predict the time for taking off ventilatior.

Key words: pulmonary disease, chronic obstructive, respiratory insufficiency, respiration, artificial

陈晓雪1，宋德刚2，孙立娟1. Tei指数评价双水平正压通气治疗COPD并发呼吸衰竭患者的右心功能[J]. 河北医科大学学报, doi: 10.3969/j.issn.10073205.2017.04.019.

CHEN Xiaoxue1, SONG Degang2, SUN Lijuan1. Evaluation of bilevel positive airway pressure ventilation therapy on right ventricular function in COPD patients combined with respiratory failure by Tei index[J]. Journal of Hebei Medical University, doi: 10.3969/j.issn.10073205.2017.04.019.

[1]	张欣. 血液CC16、PCT、FKN水平与慢性阻塞性肺疾病患者衰弱的临床研究 [J]. 河北医科大学学报, 2023, 44(9): 1027-1031.
[2]	赵圆, 杨琳, 孙超然, 杨婷, 彭文涛, 刘春艳. 下颌前移矫治器对OSAHS腭咽组织和血浆中炎症因子的影响 [J]. 河北医科大学学报, 2023, 44(8): 883-887,940.
[3]	宋海龙, 张会军. 2种术式一期根治法洛四联症中期效果对比分析 [J]. 河北医科大学学报, 2023, 44(8): 905-909,914.
[4]	胡振伐, 苏凯, 高学, 田鸣. 自身对照观察经预充气和再充气鸣人喉罩气管插管的临床效果[J]. 河北医科大学学报, 2023, 44(8): 967-971.
[5]	周莲花, 刘麟, 余庆乐, 吴蕾. 呼吸道合胞病毒下呼吸道感染患儿外周血miR-93-5p表达与Th1/Th2平衡的关系 [J]. 河北医科大学学报, 2023, 44(7): 836-839,850.
[6]	龙玉斌, 李一然, 陈伟, 贾红伟, 韩宝君, 安明. 天玑机器人辅助股骨颈动力交叉钉系统固定治疗中老年股骨颈骨折的近期效果分析 [J]. 河北医科大学学报, 2023, 44(5): 541-546.
[7]	任杰, 祖力皮喀尔·阿卜杜热合曼, 弓慧, 钟雪梅, 郑爱芳, 李黎. COPD中MicRNA-320c-5p调节SERPINA1基因表达的研究 [J]. 河北医科大学学报, 2023, 44(2): 137-141.
[8]	范素芳, 吕侯强. 血糖、炎症指标与COPD气流受限、治疗预后关联性及临床意义 [J]. 河北医科大学学报, 2023, 44(12): 1436-1441.
[9]	郭立娟, 商焕霞, 张罗元, 席素雅, 贺向红. AECOPD患者外周血NF-κB、IL-34、CCL18水平与预后的关系探讨 [J]. 河北医科大学学报, 2023, 44(10): 1141-1145.
[10]	王婷婷, 郭华, 耿宝, 范雪爱. 机械通气与非机械通气新生儿血清sTREM-1、CC16水平对呼吸机相关性肺炎的预测价值 [J]. 河北医科大学学报, 2023, 44(10): 1178-1184.
[11]	王春晓, 李志华, 徐贯杰, 张秀宁, 郄晓娟, 郝立净. 小剂量轻比重布比卡因腰椎麻醉用于老年患者髋部手术的安全性研究 [J]. 河北医科大学学报, 2022, 43(9): 1079-1084.
[12]	张孟秋（综述）, 余海（审校）. 心脏手术体外循环期间通气管理的研究现状与进展 [J]. 河北医科大学学报, 2022, 43(9): 1095-1099.
[13]	韩彩莉, 董丽萍, 乔彤, 张金俏, 张继华, 宋冬梅. OSAHS患者血清琥珀酸表达水平及其对心血管疾病发病风险的影响 [J]. 河北医科大学学报, 2022, 43(8): 895-899.
[14]	路玲, 张媛媛, 徐瑶, 吴宝华, 徐蕾, 吴海燕. 宫颈癌组织中HPV16 E6、E7蛋白水平与患者临床病理特征及预后的关系 [J]. 河北医科大学学报, 2022, 43(8): 931-934，955.
[15]	陆怡安, 包永健, 陈林. 双水平气道正压对OSAHS患者预后及血管内皮功能的影响 [J]. 河北医科大学学报, 2022, 43(7): 759-762,786.

Tei指数评价双水平正压通气治疗COPD并发呼吸衰竭患者的右心功能

Evaluation of bilevel positive airway pressure ventilation therapy on right ventricular function in COPD patients combined with respiratory failure by Tei index

HTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价