張生紅 朱芳一 馬穎

[摘要] 目的 探討無創(chuàng)正壓通氣對冠心病合并OSAHS患者心律失常的相關(guān)影響。 方法 本文選擇我院2019年10月至2020年10月收治的81例患者隨機分為觀察組（n=41）和對照組（n=40）。對照組采用單硝酸異山梨酯緩釋片、酒石酸美托洛爾片、阿司匹林腸溶片口服治療，觀察組在此基礎(chǔ)上聯(lián)合無創(chuàng)正壓通氣治療。觀察比較兩組AHI、SaO2呼吸參數(shù)，左心室收縮末期內(nèi)徑（LVESD）、左室射血分?jǐn)?shù)（LVEF）、左室舒張末期內(nèi)徑（LVEDD）及室上性心律失常、室性心律失常、心律失?？傌?fù)荷。 結(jié)果 治療后，觀察組AHI水平降低，SaO2水平升高（P<0.05），對照組AHI、SaO2水平無明顯改變（P>0.05）。觀察組LVESD、LVEDD較治療前減低，LVEF升高（P<0.05），且優(yōu)于對照組（P<0.05）。觀察組室上性心律失常、室性心律失常次數(shù)均較治療前減低（P<0.05），心律失?？傌?fù)荷無明顯改變（P>0.05）;對照組室上性心律失常、室性心律失常次數(shù)與治療前比較，差異無統(tǒng)計學(xué)意義（P>0.05），而心律失?？傌?fù)荷明顯減低（P<0.05）;且觀察組優(yōu)于對照組（P<0.05）。 結(jié)論 NPPV治療冠心病合并OSAHS心律失?；颊吲R床療效顯著，可有效改善肺通氣功能，肺內(nèi)結(jié)合，減少機體心律失常的發(fā)生風(fēng)險，穩(wěn)定心血管功能，值得推廣應(yīng)用。

[關(guān)鍵詞] 無創(chuàng)正壓通氣;阻塞性睡眠呼吸暫停低通氣綜合征;左心室收縮末期內(nèi)徑;心律失常;肺通氣功能

[中圖分類號] R541.4? ? ? ? ? [文獻(xiàn)標(biāo)識碼] B? ? ? ? ? [文章編號] 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.