经面罩双水平气道正压通气治疗充血性心力衰竭的疗效观察

The effect of bi-level positive airway pressure ventilation via facial mask on congestive heart failure

目的采用双水平气正压(BiPAP)通气治疗严重充血性心力衰竭(心衰)的治疗价值。方法对32例严重心衰患者在常规治疗的基础上采用经面罩双水平气道正压通气,以流速触发、压力支持同步呼吸。同时与另32例常规药物治疗心衰组进行对照,比较临床表现、动脉血气和心功能的变化。结果BiPAP组患者的呼吸频率减慢,心率下降,PaO2、SaO2和CaO2和射血分数显著提高(P<0.05),而血压、心输出量、心脏指数无明显变化(P>0.05),BiPAP组改善心功能的有效率为96.30%,而对照组的改善心功能的有效率仅有85.2%(P<0.05)。结论BiPAP压力支持通气能在效纠正低氧血症,改善心功能,是治疗心衰的有效措施。

Objective To vealuate the effet of bi-level posoitive airway pressure ventilation（BiPAP） via facial mask on congestive heart failure. Methods 32 patients with congestive heart failure resulted from different pathogenesis received bi level positive airway pressure ventilation via facial mask combined with routine treatment on heeart failure. The mode of ventilation was air-flow stimuli and synchronized pressure support. Other 32 controlled patients received routine treatment on heart failure. Investigating changes in clinical symptom, arterial blood gas analysis and cardiac function. Results Breath and heart rate decreased, PaO2, SaO2 and CaO2 increased significantly in the BiPAP group compared with the control grouo （p 〈 0.05 ）, while changes in bolld pre,ssure,CO and CI were not significaht （p〉0.05）. The efficacy on cardiac function improvement was 96.30% in the BiPAP group and 85.2% in the control group（p〈0.05）. Conclusion BiPAP ventilation could improve bypoxmia and cardiac function. It was an effective method in the treatment of heart failure.