无创正压通气对冠心病合并OSAHS患者心律失常的影响
2021-10-26张生红朱芳一马颖
张生红 朱芳一 马颖
[摘要] 目的 探討无创正压通气对冠心病合并OSAHS患者心律失常的相关影响。 方法 本文选择我院2019年10月至2020年10月收治的81例患者随机分为观察组（n=41）和对照组（n=40）。对照组采用单硝酸异山梨酯缓释片、酒石酸美托洛尔片、阿司匹林肠溶片口服治疗，观察组在此基础上联合无创正压通气治疗。观察比较两组AHI、SaO2呼吸参数，左心室收缩末期内径（LVESD）、左室射血分数（LVEF）、左室舒张末期内径（LVEDD）及室上性心律失常、室性心律失常、心律失常总负荷。 结果 治疗后，观察组AHI水平降低，SaO2水平升高（P<0.05），对照组AHI、SaO2水平无明显改变（P>0.05）。观察组LVESD、LVEDD较治疗前减低，LVEF升高（P<0.05），且优于对照组（P<0.05）。观察组室上性心律失常、室性心律失常次数均较治疗前减低（P<0.05），心律失常总负荷无明显改变（P>0.05）;对照组室上性心律失常、室性心律失常次数与治疗前比较，差异无统计学意义（P>0.05），而心律失常总负荷明显减低（P<0.05）;且观察组优于对照组（P<0.05）。 结论 NPPV治疗冠心病合并OSAHS心律失常患者临床疗效显著，可有效改善肺通气功能，肺内结合，减少机体心律失常的发生风险，稳定心血管功能，值得推广应用。
[关键词] 无创正压通气;阻塞性睡眠呼吸暂停低通气综合征;左心室收缩末期内径;心律失常;肺通气功能
[中图分类号] R541.4 [文献标识码] B [文章编号] 1673-9701（2021）24-0110-04
Effect of non-invasive positive pressure ventilation on arrhythmia in patients with coronary heart disease and OSAHS
ZHANG Shenghong ZHU Fangyi MA Ying
The Second Department of Arrhythmia，Qinghai Province Cardiovascular and Cerebrovascular Disease Specialist Hospital，Xining 810000，China
[Abstract] Objective To investigate the impact of non-invasive positive pressure ventilation on arrhythmia in patients with coronary heart disease and OSAHS. Methods A total of 81 patients admitted to our hospital from October 2019 to October 2020 were randomly divided into observation group （n=41） and control group （n=40）. The control group was treated with isosorbide mononitrate sustained-release tablets，metoprolol tartrate tablets， and aspirin enteric-coated tablets orally，and the observation group was treated with non-invasive positive pressure ventilation on this basis.The AHI， SaO2 respiratory parameters，left ventricular end-systolic diameter （LVESD）， left ventricular ejection fraction （LVEF）， left ventricular end-diastolic diameter （LVEDD），supraventricular arrhythmia，ventricular arrhythmia，arrhythmia total load were observed and compared. Results After treatment，the observation group's AHI level decreased， and the SaO2 level increased （P<0.05）， while the control group's AHI and SaO2 levels did not change significantly （P>0.05）.LVESD and LVEDD in the observation group after treatment decreased，and LVEF was increased （P<0.05）， which was better than the control group （P<0.05）.The frequency of supraventricular arrhythmia and ventricular arrhythmia in the observation group was lower than before treatment （P<0.05）， and the total load of arrhythmia in the observation group did not change significantly （P>0.05）.The number of supraventricular arrhythmias and ventricular arrhythmias in the control group was not significantly different from before treatment （P>0.05）.But the total load of arrhythmia was significantly reduced （P<0.05）. The above indicators of the observation group was better than the control group （P<0.05）. Conclusion NPPV has a significant clinical effect in the treatment of patients with coronary heart disease and OSAHS arrhythmia.It can effectively improve pulmonary ventilation function， integrate intrapulmonary，reduce the risk of arrhythmia in the body， and stabilize cardiovascular function. It is worthy of popularization and application.
