The Effect Of Non Invasive Positive Pressure Ventilation In The Treatment Of Overlapping Syndrome

Objective: To investigate the clinical effect of the treatment of overlap syndrome(OS)by nasal mask or mask continuous Bi-level postive airway pressure(BiPAP).Methods: Choose 37 cases of patients who underwent noninvasive mechanical ventilation in the treatment of overlap syndrome(OS)for the observation group,rom June 2013 to April 2015 in charged in the First Affiliated Hospital of Nanchang University.Meanwhile,choose 37 cases of patients who did not accepted non-invasive mechanical ventilation but only received routine symptomatic treatment for economic or other reasons as control group.Two groups were compared with arterial blood gas analysis and polysomnography(PSG),cardiac function,pulmonary function,inflammatory factor levels the fatality rate and the incidence of adverse events before and after intervention measures,to evaluate the clinical efficacy and safety of the two groups.Results:(1)24,48,72 hours arterial blood pH value of two groups of patients after treatment and partial pressure of oxygen partial pressure(PaO2)increased significantly,compared with before treatment.Carbon dioxide(PaCO2)decreased significantly(P<0.05)after treatment also.The observation group improved significantly better than the control group(P<0.05).(2)In observation group,the distal pulse average oxygen saturation(SpO2)at the night and slow wave sleep were significantly higher than the control group(P<0.05)after treatment.Apnea hypopnea index(AHI),the longest apnea time,shallow sleep and total respiratory events was significantly lower than the control group(P<0.05).(3)The patients` cardiac output and right ventricular end systolic diameter difference of the two groups had no statistical significance after treatment(P>0.05).Brain natriuretic peptide(BNP)levels of observation group was significantly lower than the control group(P<0.05).(4)The forced vital capacity(FVC),one second forced expiratory volume(FEV1),FEV1 /FVC and the maximum ventilation(MVV)of the observation group after treatment was significantly higher than the control group(P<0.05).(5)The level of interleukin-6(IL-6),tumor necrosis factor alpha(TNF-alpha)and C-reactive protein(CRP)of the two groups were significantly improved after treatment.Besides,the improvement of observation group was significantly better than the control group(P<0.05).(6)The mortality rate of the observation group was significantly lower than that of the control group(P<0.05).(7)No serious adverse reactions were observed in the observation group.Conclusion: BiPAP non invasive mechanical ventilation treatment of overlap syndrome:(1)Can effectively improve the patient’s breathing,relieve hypoxemia,hypercapnia and hypercapnia.(2)Can improve the sleep structure and quality of the patients,reduce the occurrence of respiratory apnea during sleep.(3)Can improve the pulmonary ventilation function of patients.(4)Can reduce the level of serum BNP.Prompt in the improvement of patients with right ventricular dysfunction may have the potential effect.;(5)Can reduce the level of serum IL-6 and inflammatory factor TNFalpha,reduce the systemic inflammatory reaction.