摘要
目的:评价双水平气道正压(BiPAP)无创通气对老年中晚期肺癌并心力衰竭患者心肺功能及心肌损伤标志物的影响。方法:选取老年中晚期肺癌并心力衰竭患者100例,根据治疗方法不同分为常规组和观察组,各50例,两组均予以常规治疗及护理,观察组加用BiPAP无创通气。比较两组的治疗效果、心肺功能、心肌损伤标志物水平、并发症等情况。结果:观察组治疗总有效率88.00%,显著高于常规组的66.00%(P<0.05),而并发症总发生率显著低于常规组(8.00%与30.00%,P<0.05);观察组治疗3 d后氧分压(PaO_(2))、pH值、第1秒用力呼气量(FEV1)、左心射血分数(LVEF)和每搏输出量(SV)显著高于常规组(均P<0.05),而二氧化碳分压(PaCO_(2))、呼吸频率(RR)、心率(HR)和心肌做功指数(Tei)明显低于常规组(均P<0.05);两组治疗3 d后血清心肌损伤标志物(cTnI、NT-proBNP和CK-MB)和炎症因子(TNF-α、IL-6和CRP)水平均较治疗前明显下降(均P<0.05),而观察组下降幅度更大,与常规组比较差异有统计学意义(均P<0.05)。结论:BiPAP无创通气对老年中晚期肺癌并心力衰竭患者的疗效肯定,能够增强患者的心肺功能,减轻心肌损伤,控制炎症反应,减少并发症发生率,具有较高的安全性和有效性。
Objective:To evaluate the effect of bi-level positive airway pressure(BiPAP)non-invasive ventilation on cardiopulmonary function and myocardial injury markers in elderly patients with middle and advanced lung cancer and heart failure.Methods:A total of 100 elderly patients with middle and advanced lung cancer and heart failure were selected and divided into conventional treatment group and observation group according to different treatment methods,50 cases in each group.The two groups were given conventional treatment and nursing,and the observation group was added with BiPAP non-invasive ventilation.The therapeutic effect,cardiopulmonary function,markers of myocardial injury and complications of the two groups were compared.Results:The total effective rate of the observation group was 88.00%,significantly higher than 66.00%of the conventional group(P<0.05),and the total incidence of complications was significantly lower than that of the conventional group(8.00%vs 30.00%,P<0.05).After 3 days of treatment,PaO_(2),pH,FEV1,LVEF and SV in the observation group were significantly higher than those in the conventional group(all P<0.05),while PaCO_(2),RR,HR and Tei indexe were significantly lower than those in the conventional group(all P<0.05).Compared with that before treatment,the levels of serum myocardial injury markers(cTnI,NT-proBNP and CK-MB)and inflammatory factors(TNF-α,IL-6 and CRP)in the two groups decreased significantly after 3 days of treatment(all P<0.05),while the observation group decreased more significantly than the conventional group(all P<0.05).Conclusion:BiPAP non-invasive ventilation has a positive effect on elderly patients with middle and advanced lung cancer and heart failure.It can enhance the cardiopulmonary function of patients,reduce myocardial damage,control inflammatory reaction,reduce the incidence of complications,and has high safety and effectiveness.
作者
高颖
孟蕾
GAO Ying;MENG Lei(Department of Respiratory and Critical Care Medicine,the Fourth People’s Hospital of Shaanxi Province,Xi’an 710043,China)
出处
《陕西医学杂志》
CAS
2023年第4期428-432,共5页
Shaanxi Medical Journal
基金
国家自然科学基金资助项目(82003342)。
关键词
双水平无创正压通气
中晚期肺癌
心力衰竭
老年
心肺功能
心肌损伤标志物
Bi-level non-invasive positive pressure ventilation
Middle and advanced lung cancer
Heart failure
Old age
Cardiopulmonary function
Myocardial injury markers
