机械通气抢救急性左心衰竭伴呼吸衰竭的临床观察

The use of mechanical ventilation in acute left heart failure patients

目的评价机械通气治疗急性左心衰竭的疗效。方法对32例常规治疗无效的重症急性左心衰竭患者加用机械通气治疗，观察通气前后HR、RR、平均动脉压（MAP）、动脉血气分析指标（pH、PaO2、SaO2、PaCO2）的变化及临床症状的改善情况。结果机械通气治疗后，32例患者中28例病情好转，4例死亡。通气1h后RR由（33．6±7．8）次／min降至（21．3±3．2）次／min（P〈0．05），HR由（117．8±17．5）次／min降至（86．7±10．5）次／min（P〈0．05），MAP由（96．4±5．2）mmHg降至（83．9±7．8）mmHg（P〈0．05）。通气前及通气后1h查血气，SaO2由（75．8±8．6）％升高至（95．6±3．7）％（P〈0．01），PaO2由（49．8±8．7）mmHg升高至（85．3±6．1）mmHg（P〈0．01），pH、PaCQ元显著变化。结论机械通气是治疗急性左心衰竭伴呼吸衰竭安全有效的方法。

Objective To evaluate the efficacy of mechanical ventilation in acute left heart failure. Methods 32 patients with acute left heart failure, routine treatmems unsuccessful, use mechanical ventilation. Observe the change of heart rate, respiration rate, mean artery pressure, blood gas analysis（ pH, PaO2, SaO2, PaCO2 ） and clinical Symptoms. Results After mechanical ventilation, the clinical symptoms of 28 patients were improved, 4 patients were dead. After one hour mechanical ventilation, respiration rate decreased from （33.6±7.8）/min to （21.3±3.2）/min（P〈0.05）,heart rate decreased from （117.8±17.5）/min to （86.7±10.5）/min（P〈 0.05）,mean artery pressure decreased from （96.4 ±5.2）mmHg to （83.9±7.8）mmHg（P〈 0.05） ,SaO2 increased from （75.8 ±8.6）% to（95.6±3.7）%（P〈0.01）,PaO2 increasedfrom （49.8±8.7） to （85.3±6.1）（P〈0.01）,pHand PaCO2 have no significant improve. Conclusion Mechanical ventilation is a safe and effective treatment for acute left heart failure patients.