急性左心衰竭患者无创正压通气中吗啡的作用

Eeffects of morphine on NPPV in patients with acute left ventricular failure

目的观察吗啡对急性左心衰竭(ALVF)患者无创正压通气(NPPV)的影响。方法15例应用NPPV的急性左心衰患者,常规药物治疗中,比较吗啡治疗前后,动脉血气分析(PaO2、PaCO2、SaO2)、心率(HR)、平均动脉血压(MAP)、呼吸频率(RR)、呼气潮气量(VT)、分钟通气量(VE)和通气依从性的变化。结果本组急性左心衰竭患者治疗有效率87%。吗啡治疗后无创通气依从性明显提高。治疗后3hHR、RR显著降低(P<0.001),MAP稳定;PaO2显著增高(P<0.001),PaCO2显著降低(P<0.05);呼吸机VE降低(P<0.001),呼气VT变化不明显(P>0.05)。结论吗啡改善ALVF患者NPPV治疗依从性,NPPV提高吗啡的安全性。

Objective To evaluate the effects of morphine on noninvasive positive pressure ventilation （NPPV） in patients with acute left ventricular failure （ALVF）. Methods Fifteen patients with ALVF were treated by NPPV and traditional drugs. Major physiological data and ventilation parameters were recorded before and after the treatment using morphine. Results Three hours after treatment, there were some changes of the parameters as follows： the total efficiency rate was 87%. The patients＇compliance with NPPV therapy increased after the use of morphone （ from 27% to 93% ）. Mean arterial pressure fell slightly. PaO2 increased and PaCO2 decreased significantly after the treatment. The patients＇respiratory rates and Vt improved. The Ve was unchanged. Conclusion Morphine improves the compliance of NPPV, which in turns improves the safety of morphine.