摘要目的 观察无创正压通气治疗对慢性阻塞性肺疾病致慢性肺源性心脏病合并全身水肿患者尿量的影响.方法 2007年1月至2008年8月入住我科的慢性阻塞性肺疾病致慢性肺源性心脏病合并全身水肿患者55例,均给予氧疗、抗感染、化痰、扩张气道治疗.除上述治疗外,其中19例(A组)接受无创正压通气治疗每天16 h以上;16例(B组)给予口服利尿剂氢氯噻嗪25 mg/d加螺内酯40 mg/d(B组);其余20例(C组)患者未接受无创正压通气或口服利尿剂.观察入选患者住院期间尿量,计算出每例患者的日平均尿量并做记录(单位ml/24 h).将三组记录作比较.结果 A组尿量为(1972±110)ml/24 h,B组为(1750±125)ml/24 h,C组为(1408±117)ml/24 h,三组结果相比差异有统计学意义(P＜0.01).结论 无创正压通气治疗能明显增加慢性阻塞性肺疾病致慢性肺源性心脏病合并全身水肿患者的尿量,达到减轻水肿的目的 ,较口服利尿剂效果更明显.

abstractsObjective To observe the effect of noninvasive positive pressure ventilation (NPPV)on urinary volume in patients with chronic cor pulmonale combined with general dropsy caused by chronic obstructive pulmonary disease.Methods From January 2007 to August 2008,55 patients with chronic cor pulmonale combined with general dropsy caused by chronic obstructive pulmonary disease were enrolled in this study.All patients received oxygen therapy,anti-infection,dissipate phlegm and to airway dilation,and they were randomly divided into three group. Patients in group A(19 cases)received noninvasive positive pressure ventilation for more than 16 hours per-day;Patients in group B(16 cases)were given hydrochlorothiazide 25 mg/d and spironolactone 40 mg/d.Patients in group C(20 cases) didn't received NPPV or oral diuretics.Observe urinary volume of all the enrdled patients,and daily mean urinary volume of each patient was calculated and recorded(ml/24 hour).Compare the records between three groups.Results The wrinary volume in group A was(1972±110)ml/24 h,(1750±125)ml/24 h in group B and(1408±117)ml/24 h in group C.There were significant differences between the three groups(P＜0.01).Conclusions NPPV may increase urinary volume obviously of the patients with chronic cor pulmonale combined with general dropsy caused by chronic obstructive pulmonary diseaes,so can lessen edema,and the effect is more obvious than oral diuretic.