经面罩双水平正压通气治疗急性左心衰的临床应用

Clinical Use of Face Mask Bilevel Positive Airway Ventilation in Patients with Acute Left Ventricular Failure

目的观察应用经面罩双水平正压通气(BiPAP)治疗急性左心衰的临床价值。方法38例患者经常规药物治疗,症状仍未能缓解,且存在明显的低氧血症的急性左心衰患者入选。观察应用BiPAP治疗前后患者症状、体征以及血气分析的变化。结果应用BiPAP治疗后,33例患者呼吸困难改善,心率、呼吸频率明显减慢;动脉血氧分压(55.3±11.76mmHgvs.86.5±8.06mmHg,P<0.01)和动脉血氧饱和度(85.6±9.41%vs.95.4±5.81%,P<0.01)明显提高。5例患者呼吸困难无缓解改用气管插管进行机械通气,1例患者死于心跳、呼吸骤停。结论急性左心衰应用BiPAP治疗可明显改善患者的低氧血症和心功能,是抢救急性左心衰的一种安全有效的方法。

Objective To evaluate the clinical value of bilevel positive airway ventilation （ BiPAP ） in patients with acute left ventricular failure. Methods 38 acute left ventricular failure patients with hypoxemia failed to routine therapy were enrolled. The symptoms, signs and artery blood gases were analyzed before and after BiPAP therapy. Results After BiPAP therapy, dyspnoea was improved in 33 patients, heart rates and breathing rates reduced significantly, the partial pressure of oxygen （55.3：t：11.76 mm/-/g vs. 86.5±8.06 mmHg, P〈 0.01 ） and arterial saturation of oxygen （85.6±9.41 vs. 95.4±5.81, P〈0.01 ） increased markedly. 5 patients received mechanical ventilation followed urgent tracheal intubation, and 1 patient died. Conclusions The noninvasive mask BiPAP can improve hypoxemia and cardiac function markedly in patients with acute left ventricular failure, and BiPAP is a safe and effective method in the treatment of acute left ventricular failure.