机械通气抢救急性左心衰竭患者的临床疗效观察

Clinical Observation of Mechanical Ventilation in the Treatment of Acute Left Heart Failure

【目的】观察机械通气在急性左心衰竭患者治疗中的作用。【方法】30例急性左心衰竭患者在常规治疗的基础上,24例采用经鼻面罩双水平气道正压支持通气(BiPAP),效果或合作不佳者6例采用气管插管同步间歇指令通气(SIMV)+呼气末正压通气(PEEP),观察心率、血压、呼吸频率、血氧饱和度、血气分析及机械通气1 h后的变化。【结果】28例急性左心衰患者应用机械通气1 h后,心率、血压、呼吸频率、血氧饱和度、血氧分压均有非常明显的改善,临床症状明显缓解,2例因原发病严重进一步恶化而死亡。【结论】机械通气治疗急性左心衰竭能迅速改善患者症状和低氧血症,是救治急性左心衰竭安全有效的辅助治疗方法。

[Objective] To observe the curative effects of mechanical ventilation in the treatment of acute left heart failure. [Methods]A total of 30 patients with acute left ventricular failure received conventional treatment, in which of 24 patients received nasal mask bi-level positive airway pressure （BIPAP） support ventilation and 6 patients received the intubation synchronized intermittent mandatory ventilation （SIMV） ＋ positive end expiratory pressure（PEEP） ventilation. Heart rate, blood pressure, respiratory rate, saturation of blood oxygen and blood gas analysis were observed and compared before and after ventilation. [Results] After mechanical ventilation for 1 hour, 28 patients with acute left heart failure were improved in heart rate, blood pressure, respiratory rate, saturation of blood oxygen and partial pressure of blood oxygen, and clinical symptoms relieved. Two patients died due to the serious deterioration of primary disease. [Conclusion] The mechanical ventilation could effectively improve symptoms and hypoxemia caused by acute left heart failure. It is an effective and safe supplementary therapy in successfully rescuing patients with left heart failure.