无创正压机械通气治疗重度急性左心功能衰竭对患者血气和肺功能的影响

Effects of noninvasive positive pressure ventilation on arterial blood gas and pulmonary function in severe left heart failure

目的了解无创正压机械通气治疗重症急性左心功能衰竭对患者血气及肺功能的影响。方法将40例严重急性左心功能衰竭患者随机分为对照组和无创通气组,每组各20例。对照组用常规药物治疗,无创通气组在对照组的基础上加用无创正压机械通气治疗。比较治疗1h和2h后两组动脉血中pH、PaO2、PaCO2的变化以及治疗2h后两组肺功能中PEF、FEV1.0/FVC的改变。结果无创通气组在治疗后较对照组PaO2、PaO2/FiO2升高、PaCO2降低,差异具统计学意义(P<0.05或0.01)。治疗后,无创通气组的PEF、FEV1.0/FVC明显高于对照组(P<0.05或0.01)。结论无创正压机械通气可降低气道阻力,改善患者肺泡的氧合功能以及肺的顺应性,是抢救重症急性左心功能衰竭患者的一种安全有效的方法。

Objective To study the effects of noninvasive positive pressure ventilation （NPPV） on arterial blood gas and pulmonary function in patients with severe acute left heart failure （ALHF）. Methods Forty cases of severe ALHF were randomly divided into two groups. Control group received conventioal medication, whereas ventilation group were treated by NPPV and conventioal medication. Arterial blood gas analysis and pulmonary function were determined before and 1-2 hours after treatment. Results Compared with control group, PaO2, PaO2/FiO2, PEF and FEVI.o/FVC increased, but PaCO2 decreased significantly in ventilation group after treatment （P 〈 0.01 or 0.05）. Conclusion NPPV is safe and effective in rescuing patients with severe ALHF by way of decreasing the airway resistance and improving the pulmonary oxygenation and compliance.