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目的观察无创通气联合法舒地尔治疗老年肺心病伴呼吸衰竭患者的疗效。方法选取2015年1月—2016年7月就诊的老年肺心病伴呼吸衰竭患者90例,随机分为观察组和对照组各45例。对照组给予常规治疗,同时无创机械通气治疗。观察组则在对照组的基础上给予30 mg法舒地尔降肺动脉压,1次/12 h。两组观察时间为72 h。比较两组治疗前后的血氧饱和度(Oxygen saturation,SaO_2)、二氧化碳分压(Partial Pressure of Carbon Dioxide,PaCO_2)、氧分压(Partial Pressure of Oxyge,PaO_2)、脑钠肽(Brain Natriuretic Peptide,BNP)及肺动脉收缩压水平,评价两组的治疗效果。计量资料比较采用t检验,计数资料比较采用χ2检验。P<0.05为差异有统计学意义。结果与治疗前比较,两组SaO_2、PaO_2升高,PaCO_2、BNP、肺动脉收缩压均下降(均P<0.05)。观察组SaO_2升至(90.6±6.3)%,PaCO_2降至(45.3±5.7)mm Hg,PaO_2升至(78.3±6.9)mm Hg,BNP降至(116.3±28.2)ng/L,肺动脉收缩压降至(55.2±9.3)mm Hg,与对照组比较,差异有统计学意义(均P<0.05)。观察组总有效率为86.7%,高于对照组的62.2%(P<0.05)。结论无创通气联合法舒地尔对老年肺心病伴慢性衰竭进行治疗,不仅能改善心功能,还能够强化通气功能。
Objective To observe the curative effect of noninvasive ventilation combined with fasudil in elderly patients with pulmonary heart disease and respiratory failure. Methods From January 2015 to July 2016, 90 elderly patients with pulmonary heart disease and respiratory failure were randomly divided into observation group (45 cases) and control group (45 cases). Control group given conventional treatment, while non-invasive mechanical ventilation treatment. The observation group was given 30 mg fasudil on the basis of the control group, pulmonary artery pressure, 1/12 h. The observation time was 72 h in both groups. Oxygen saturation (SaO_2), partial pressure of carbon dioxide (PaCO_2), partial pressure of oxygen (PaO_2) and brain natriuretic peptide (Peptide, BNP) and pulmonary arterial systolic blood pressure, evaluate the therapeutic effect of the two groups. Measurement data were compared using t test, count data were compared using χ2 test. P <0.05 for the difference was statistically significant. Results Compared with those before treatment, both SaO_2 and PaO_2 increased and PaCO_2, BNP and pulmonary systolic pressure decreased in both groups (all P <0.05). PaO2 decreased to (45.3 ± 5.7) mm Hg, PaO_2 increased to (78.3 ± 6.9) mm Hg, BNP decreased to (116.3 ± 28.2) ng / L, and pulmonary artery systolic pressure drop To (55.2 ± 9.3) mm Hg, compared with the control group, the difference was statistically significant (P <0.05). The total effective rate in observation group was 86.7%, higher than that in control group (62.2%, P <0.05). Conclusion Non-invasive ventilation combined with fasudil treatment of elderly patients with pulmonary heart disease and chronic failure, not only can improve cardiac function, but also can strengthen the ventilation function.