家庭无创机械通气对慢性阻塞性肺疾病患者生活质量影响.doc

家庭无创机械通气对慢性阻塞性肺疾病患者生活质量影响【摘要】目的 观察家庭无创机械通气对慢性阻塞性肺疾病稳定期患者生活质量的影响。方法2008年8月至2010年6月间选择接受无创正压机械通气（non-invasive positive pressure ventilation，NPPV)）并携带家庭型呼吸机返家的慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）病例9例设为治疗组；选择同期同样病情住院期间接受无创机械通气出院后氧气治疗病例12例作为对照组。对照组采用常规治疗，治疗组在常规治疗基础上进行面罩双水平气道正压无创通气治疗（bi-1evel positive airway pressure，BiPAP）。结果 治疗组在1年内住院次数、单次住院天数及圣乔治(SGRQ)评分均优于对照组,差异有统计学意义。结论 家庭无创机械通气能有效缓解慢性阻塞性肺疾病患者病情的进展,减少患者住院时间,提高患者生活质量。 【关键词】肺疾病 阻塞性无创机械通气 生活质量 中图分类号：R563文献标识码：B文章编号：1005-0515（2011）1-039-02 Effect of Domiciliary Non-invasive Ventilation on Quality of Life in Patients with Chronic Obstructive Pulmonary Disease Li Tie-ying，Li Hua （Department of Respiratory Disease, The General Hospital of Benxi Iron and Steel Company，Benxi 117000，China） 【Abstract】Objective To investigate the effects of non-invasive ventilation on quality of life in COPD patients. Methods From Aug.2008 to Jun.2010，21cases conducted by NPPV via facial mask in COPD patients were involved in the study. Sequence from hospital to home by NPPV in 9 cases was used as therapy group. At the same time of hospitalization，other 12 cases with similar clinical characteristics who received the inspiration of oxygen after be discharged from hospital were studied as control group. Results There was significant statistical differences between the two groups，which shows that the therapy group was superior to the control group in the times of hospitalization yearlong days，single hospitalization and the integration of SGRQ. Conclusion Domiciliary non-invasive ventilation can slow down the progression of COPD，reduce the time of 自20世纪90年代初应用于临床治疗COPD以来，已有大量临床研究证实无创机械通气对慢性阻塞性肺疾病急性加重的疗效确切[1]，可以降低病死率与插管率[2]，但对于COPD稳定期患者是否需要无创机械通气尚存在争议[3~6]，本研究以家庭无创机械通气为研究对象，并选圣乔治(SGRQ)评分、1年内住院次数和单次住院天数等指标进行研究，观察其对患者生活质量的影响。 1 资料与方法 1.1资料 21例COPD患者（男16，女5，年龄56±34）均符合中华医学会呼吸病学分会COPD诊治指南[7]。 1.2 分组 治疗组：2008年8月至2010年6月因COPD急性加重期合并Ⅱ型呼吸衰竭和/或肺性脑病收入重症监护室（intensive care unit, ICU）接受美国伟康公司S/T30型BiPAP呼吸机无创正压通气，通气功能改