无创通气治疗外科术后急性左心衰对血气分析和肺功能的影响

Effects of noninvasive ventilation for treating postoperation acute left heart failure on arterial blood gas and pulmonary function

目的研究无创通气在治疗外科术后急性左心衰时对pH、PaO2、PaCO2以及PEF、FEV1%的影响。方法将40例外科术后急性左心衰的患者随机分为两组,即常规药物治疗组（对照组）和无创通气＋药物治疗组（无创通气组）,每组各20例,比较治疗1、2h后,两组动脉血气分析中的pH、PaO2、PaCO2变化以及2h两组肺功能中PEF、FEV1/FVC的改变。结果无创通气组在治疗后PaO2、PaO2/FiO2升高、PaCO2降低较对照组显著（P〈0.05～0.01）。无创通气组在治疗后PEF、FEV1/FVC的提高较对照组显著（P〈0.05～0.01）。结论无创通气在外科术后急性左心衰治疗中可降低气道阻力,改善患者的肺泡的氧合功能以及肺的顺应性。

Objective To study the influence of noninvasive ventilation on pH, PaO2, PaCO2 in arterial blood gas and PEF, FEV 1/FVC in pulmonary function of post-operation patients with moderate to severe acute left heart failure. Melhods Forty cases of post-operation patients with acute left heart failure were randomly divided into two groups. One group was treated only by drugs （control group）, the other group were treated by noninvasive ventilation and drugs （ventilation group）. The changes of pH, PaO2, PaCO2 in the arterial blood gas before and after the treatment between the two groups were compared, and also the changes of PEF, FEV1/FVC in pulmonary function before and after treatment between the two groups were compared. Results Compared to control group, PaO2, PaO2/FiO2 were increased and PaCO2 decreased in the ventilation group, and also the PEF, FEV1/FVC were increased significantly in the ventilation group （P〈 0.05-0.01）. Conclusion The use of noninvasive ventilation in treating post-operation patients with acute left heart failure can decrease airway resistance and improve the oxygenation in lung.