无创双水平气道正压通气在治疗重度充血性心力衰竭中的作用

Application of noninvasive bi-level positive airway pressure ventilation in treating patients with severe congestive heart failure

目的探讨无创双水平气道正压通气(BiPAP)对重度充血性心力衰竭的作用。方法选择34例次经常规方法治疗无效的重度充血性心力衰竭患者进行BiPAP,记录临床症状体征、Boston心衰积分、彩色多普勒二维超声心动图、血气分析及运动耐力等指标监测。结果34例重度充血性心力衰竭患者抢救成功28例次,抢救成功率824%。治疗4h后生命体征稳定、心衰减轻,PaO2和SaO2明显提高(P<001);3d后心脏射血分数及运动耐力明显增加(P<001)。结论无创双水平气道正压通气通过调节适当吸气压力水平和呼气末正压水平,可改善心功能,减轻肺水肿,迅速提高动脉血氧含量。

Objective To study the effects of noninvasive bi-level positive airway pressure ventilation on severe congestive heart failure.Methods 34 patients with severe congestive heart failure who exhibited poor response to conventional therapy were treated with noninvasive bi-level positive pressure ventilation.Clinical symptoms,signs,Boston's record,two-dimensional color Doppler echocardiogram,blood gas analysis and exercise endurance were monitored.Results 28 patients survived with a success rate of 82.4%.Significant improvements of vital signs,PaO_2 and SaO_2 could be found (P<0.01) 4 hours after ventilation.Ejection fraction and exercise endurance were improved markedly (P<0.01) 3 days after ventilation.Conclusion Noninvasive bi-level positive pressure ventilation could decrease the pulmonary edema,elevate PaO_2 and SaO_~2 and promptly improve heart function.