机械通气治疗老年急性左心衰竭的初步经验

Preliminary Experience of Mechanical Ventilation on the Treatment of A ged Patients with Acute Left Ventricular Failure.

目的 探讨老年急性左心衰时机械通气的疗效及适应症。方法 2 5例急性左心衰竭患者 ,予常规吸氧或高流量面罩吸氧及积极药物治疗同时 ,适时给予气管插管机械通气 ,并观察记录 1～ 2小时后患者重要生理参数改变 ,进行统计分析。结果 2 3例 (92 % )患者病情迅速控制或好转 ,低氧血症及呼吸性酸中毒纠正。治疗后 1～ 2小时 ,血气分析PH、PaO2 、PaCO2 及SaO2 明显改善。分别为 [(7 12± 0 0 5 )vs(7 34± 0 0 2 ) ,P<0 0 0 1,(5 4 6± 13 1)vs(83 4± 2 0 9)mmHg,P <0 0 0 1,(95 5± 18 3)vs(5 6 2± 2 0 9)mmHg ,P <0 0 0 1,(6 5 5±3 1)vs(92 6± 5 7) % ,P± <0 0 0 1]。平均血压无明显改变 [(91 6± 2 1 0 )vs(92 5± 17 7)mmHg ,P >0 0 5 ],心率明显改善。 [(116± 18 6 )vs(10 2± 12 8)次 /分 ,P <0 0 0 1]。结论 老年急性左心衰竭患者 。

Objective To investigate the effect, indication a nd methods of mechanical ventilation (MV) in aged patients with acute left ventr icular failure. Methods 25 aged patients with acute left ventric u lar failure were treated with MV at correct time besides other medical therapy a nd delivered conventional or high flow oxygen with face mask. Major physilolgica l date were recorded after 1～2 hours of MV therapy. Results 23 pati ents(92%) were improved dramatically in 1～2 hours. Analysis of blood gas showed that PH, PaO 2, PaCO 2 and SaO 2 changed significantly[(7.12±0.05)Vs (7.34±0.02),P<0.001,(54.6±13.1) Vs (83.4±20.9),P<0. 001,(98.5±18.3)Vs (56.2±20.9),P<0.001,(65.5±3.1)Vs (92 .6±5.7),P<0.001, respectively]. While mean blood pressure (MAP) did not show any significantly changes [(91.6±21.0) Vs (92.5±17.7),P <0.25],Heart rate (HR) improved [(116±18.6) Vs (102±12.8),P<0 .001]. Conclusions For the aged patients with acute left ventr icular failure, MV at correct time is effective method to increase success rate of emergency care.[