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Objective To investigate the effect of non －invasive ventilator in the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS) and the effect on C－reactive protein (CRP),endothelin－1(ET－1) and tumor necrosis factor －alpha (TNF－α).Methods From February 2016 to August 2017,86 patients with moderate and severe OSAHS in the First People's Hospital of Jinzhong were divided into the observation group and the control group according to the different treatment methods ,with 43 cases in each group.The observation group was treated with noninvasive ventilator ,and the control group was treated with conservative treatment .The differences of PSG and inflammatory factors were compared between the two groups before and after treatment ,and the correlation between AHI,ODI,LSpO2,MSpO2and CRP,ET－1,and TNF－αwas analyzed.Results After treatment,AHI,ODI,MSpO2 of the two groups were decreased significantly ,LSpO2increased significantly,and the AHI [(13.7 ±8.6)times/h vs. (43.1 ±13.6)times/h],ODI [(15.4 ±12.9)times/h vs.(42.5 ±12.6)times/h],LSpO2[(79.6 ±16.8)% vs. (62.3 ±19.27)%],MSpO2[(92.2 ±25.6)% vs.(80.3 ±30.4)%] in the observation group were better than those in the control group,the differences were statistically significant (t ＝5.291,4.258,3.998,4.651,all P＜0.05).After treatment,the levels of CRP,ET－1,TNF －αin the observation group were decreased significantly , which in the control group had no statistically significant differences compared with those before treatment .After treat－ ment,the CRP [(3.7 ±0.7)mg/L vs.(6.1 ±1.8)mg/L],ET－1 [(32.3 ±11.9)ng/L vs.(46.5 ±16.6)ng/L], TNF－α[(19.1 ±3.2)ng/L vs.(31.3 ±9.2)ng/L] in the observation group were significantly lower than those in the control group,the difference were statistically significant (t＝8.255,6.594,5.227,all P＜0.05).After Pearson correlation analysis,AHI and ODI were positively correlated with CRP,ET－1 and TNF－α(r＝0.33,0.56,0.44, 0.26,0.55,0.63),while LSpO2and MSpO2were negatively correlated with CRP,ET－1,TNF－α(r＝－0.36,－0.44,－0.54,－0.28,－0.36,－0.59).Among them,the positive correlation coefficient of ODI and TNF －αwas the largest(0.63).The negative correlation coefficient of MSpO2 and TNF－was the largest(－0.59).Conclusion Non－invasive ventilator in the treatment of OSAHS is effective and can obviously reduce the level of inflammatory factors in the body.
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Objective To investigate the effect of nikethamide combined with noninvasive ventilator in the treatment of chronic obstructive pulmonary disease ( COPD) complicated with respiratory failure.Methods 127 cases with COPD complicated with respiratory failure in our hospital from February 2014 to March 2016 were selected and randomly divided into observation group (72 cases) and control group (55 cases), the control group was treated with noninvasive ventilator therapy, and the observation group was treated with the therapy of nikethamide on the basis of the control group, the therapeutic effect, blood gas changes, etc of two groups were observed.Results The effective rate of the observation group was 80.56%, significantly higher than that of the control group (63.64%), the difference was statistically significant (P<0.05), the observation group after treatment 24h and 72 h pH and oxygen partial pressure (PaO2) were significantly higher than the control group, while the carbon dioxide partial pressure (PaCO2) was significantly lower than the control group, the difference was statistically significant (P<0.05), after treatment 24h and 72 h APACHE II scores in the observation group were (20.20 ±2.71) and (18.01 ±1.16), significantly lower than that of the control group, the difference was statistically significant (P<0.05), the hospitalization time, tracheal intubation rate and mortality rate of the observation group were (14.82 ±4.61) d, 11.11%and 4.17%, which were significantly less than those in the control group, the difference was statistically significant ( P <0.05 ) . Conclusion Noninvasive ventilator combined with nikethamide in the treatment of COPD combined with respiratory failure , can improve the effect of noninvasive ventilation, reduce the rate of tracheal intubation in patients.
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Objective To investigate the effect of Shenmai injection combined with noninvasive ventilator on MDA , SOD and clinical efficacy in treatment of elderly patients with chronic respiratory failure.Methods 72 cases of elderly patients with chronic respiratory failure were randomly divided into control group and experimental group.Control group of 35 patients were treated with conventional therapy and the treatment of noninvasive ventilator, experimental group of 37 patients were treated combined with Shenmai injection for 1 weeks.The level of serum MDA, SOD and clinical efficacy were compared.Results The serum MDA level was decreased, SOD level increased in 2 groups after treatment (P<0.05), the level of MDA in experimental group was lower than control group, and the level of SOD was higher (P<0.05).The level of PaO2 was increased, PaCO2 level and QOL score decreased,the level of PaO2 in experimental group was higher than control group, the QOL score was lower than that of control group ( P<0.05),and there was no difference in PaCO2.After treatment, the total effective rate of experimental group was significantly higher than control group (P<0.05).Conclusion Shenmai injection combined noninvasive ventilator is effective on elderly patients with chronic respiratory failure, it can reduce serum MDA level, increase the serum SOD level.
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Objective To investigate the efficacy and security of noninvasive ventilator assisted ventilation combined with morphine in treating acute left heart failure.Methods Sixty patients suffering acute left heart failure were divided into two groups:conventional therapy group (thirty cases using morphine and other medicine) and combined group (thirty cases using noninvasive ventilator assisted ventilation combined with morphine).Observe and record clinical results for blood pressure,heart rate,respiratory rate,blood gas analysis,left ventricular ejection fraction (LVEF) as well as occurrence rate of remission time and adverse reaction before treatment,one hour after treatment and remission respectively.Results Clinical results for blood pressure,heart rate,respiratory rate,blood gas analysis,left ventricular ejection fraction (LVEF) have improved after treatment,all clinical indexs have improved obviously except for partial pressure of carbon dioxide in combined group.The difference was significant (P ＜ 0.05) ; Remission time in combined group (6.20 ± 4.12 hours) was shorter than morphine group (8.67 ± 5.28) hours,which has statistically difference (P ＜ 0.05).But occurrence rate of adverse reaction and complication raised slightly in combined group (43.3％ vs.40％).Conclusions Noninvasive ventilator assisted ventilation combined with morphine can relieve clinical symptoms promptly in acute left heart failure,improve prognosis,it is a effectively and safety therapeutic measures.
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PURPOSE: A general analysis of patients in the Emergency Department (ED) and the Intensive Care Unit (ICU) was performed to evaluate the effectiveness of a noninvasive ventilator (NIV) for the effective treatment of patients in respiratory distress without using endotracheal intubation. METHODS: The 38 patients who were treated with a NIV from December 1, 2001, to September 31, 2002, were studied. The ER doctors investigated prospectively sex, age, the causes of disease, the main symptoms, the duration of treatment, the mode of ventilation, the vital signs and the arterial blood gas analysis at the time of admission and after 30 minutes of NIV use, adaptation of patients, complications, and the success or failure of the treatment. RESULTS: 1) General features: Out of 38 cases, 25 males and 13 females, the average age was 60.61 years old. In group X (treatment success), the average age was significantly lower than it was in group Y (treatment failures). 2) The causes of disease and symptoms: The causes of disease were as follows: asthma and chronic obstructive pulmonary disease, 13 patients; drug intoxication, 8 patients; pulmonary edema, 8 patients; respiratory failure, 2 patients; lung contusion, 3 patients; pneumonia, 2 patients. 3) Adaptation and complications: 11 patients adapted well, 18 patients adapted normally, and 11 patients failed. Complications were minimal and included gastric distension in 2 patients and xerophthalmia in another 2. 4)Vital signs and arterial blood gas analysis results: The arterial blood gas analysis performed after 30 minutes in treatment showed improved results, but only the pH had any effect on success or failure. CONCLUSION: NIV had a success rate of 72%. The factors influencing success were surveyed according age, pH level before treatment, pH P a C O2 S a O2 30 minutes after treatment, and adaptation.