中国中西医结合急救杂志2025，Vol.32Issue(2)：171-176,6.DOI:10.3969/j.issn.1008-9691.2025.02.009
正压氧疗联合药物改善肺循环能提高高海拔地区重症病毒性肺炎疗效的研究
Positive pressure oxygen therapy combined with drugs to improve pulmonary circulation can improve the treatment efficiency of severe viral pneumonia at high altitude areas
摘要
Abstract
Objective To observe the efficacy of positive pressure oxygen therapy combined with drugs to improve pulmonary circulation in the treatment of severe viral pneumonia in high-altitude areas.Methods A two-way cohort study was conducted.Patients with severe viral pneumonia and those with common viral pneumonia complicated with underlying heart and lung diseases admitted to department of intensive care unit of Xizang Autonomous Region People's Hospital were selected as the research subjects.Patients who received conventional treatment in the early stage were assigned to the control group,while those who received conventional treatment plus active positive pressure oxygen therapy combined with drugs to improve pulmonary circulation in the later stage were assigned to the study group.The treatment effective rates of the two groups were observed(including the time for viral nucleic acid to turn negative,hospital stay,and 28-day follow-up mortality)and changes in cardiopulmonary function indicators[pulmonary artery pressure,tricuspid annular plane systolic excursion(TAPSE),left ventricular stroke volume(SV),and lung ultrasounol score(LUS)]before and after treatment were also observed,and the Kaplan-Meier curve was drawn to analyze the 28-day cumulative survival rate of the two groups.Results There was no statistically significant difference in the time for viral nucleic acid to turn negative and hospital stay between the two groups.Compared with the control group,the 28-day mortality in the study group was significantly lower[6.5%(2/31)vs.25.0%(13/52),P<0.05].Compared with before treatment,pulmonary artery pressure gradually decreased,TAPSE significantly increased,and left ventricular SV significantly increased after treatment in the study group,and the differences were statistically significant compared with 10 days after treatment[pulmonary artery pressure(mmHg,1 mmHg≈0.133 kPa):28.84±8.71 vs.34.68±10.76,TAPSE(cm):2.37±0.11 vs.2.03±0.41,SV(mL):68.68±7.17 vs.59.61±6.73,all P<0.01].Pulmonary lesions,especially bilateral pulmonary exudative lesions,significantly improved compared with before treatment,atelectasis improved significantly,and LUS significantly decreased(14.77±5.33 vs.20.32±5.63,P<0.01).Kaplan-Meier curve analysis showed that the 28-day cumulative survival rate in the study group was significantly higher than that in the control group(Log-Rank test:χ2=4.510,P=0.034).Conclusion Active use of positive pressure ventilation and early administration of drugs to improve pulmonary circulation in patients in high-altitude areas can significantly reduce pulmonary artery pressure and significantly improve left and right heart function and pulmonary exudative lesions.These improvements may reduce the mortality rate of viral pneumonia and viral infections complicated with underlying heart and lung diseases in high-altitude areas.关键词
正压氧疗/药物/肺动脉高压/高海拔地区Key words
Positive pressure oxygen therapy/Medication/Pulmonary arterial hypertension/High altitude areas/Viral pneumonia引用本文复制引用
蔺国英,徐宗涛,蔡鑫,李茜玮,罗巧侠,吕杰..正压氧疗联合药物改善肺循环能提高高海拔地区重症病毒性肺炎疗效的研究[J].中国中西医结合急救杂志,2025,32(2):171-176,6.基金项目
西藏自治区科技厅新冠感染防控科技攻关项目(XZ202201ZY0053G) COVID-19 Infection Prevention and Control Science and Technology Research Project of the Science and Technology Department of the Xizang Autonomous Region(XZ202201ZY0053G) （XZ202201ZY0053G）
