无创正压通气治疗急性左心衰竭20例观察

Clinical study on noninvasive positive pressure ventilation in the treatment of 20 patients with acute left ventricular failure

目的:观察无创正压通气(NIPPV)治疗急性左心衰竭(ALVF)的临床疗效。方法:ALVF患者40例,随机分为NIPPV治疗组和对照组(常规药物治疗)各20例。观察两组患者治疗前及治疗后24h心率、呼吸、血压、肺部啰音及血气分析的变化,监测两组治疗前、治疗后24h平均左心室射血分数(LVEF),并比较两组治疗总有效率、APACHEⅡ评分情况和平均住院天数。结果:NIPPV治疗组无创通气24h后的心率和呼吸明显减慢(P<0.01),肺部啰音明显减少,呼吸困难均改善,心功能均有进步,总有效率100%,通气24h后PaO2和SaO2显著升高(P<0.05)。对照组总有效率为73.33%。两组治疗前后APACHEⅡ评分和平均住院天数也有明显差异(P<0.05)。结论:NIPPV治疗ALVF能够及时缓解症状,改善左心功能。

Objective：To observe the therapeutic efficacy of noninvasive positive pressure ventilation in the treatment of acute left ventricular failure（ ALVF） . Methods： Forty patients with ALVF were randomized to acontrol group and a treatment group. In addition to conventional therapy,the treatment group were treated with noninvasive positive pressure ventilation. The changes of clinical symptoms and arterial blood gases were measured. The APACHEⅡ scores and hospital stays were analyzed,and the hemodynamic parameters were detected before and after ventilation. Results： The treatment group showed more significant improvement in clinical symptoms,APACHE Ⅱ scoring,and fewer hospital stays compared with the control group （ P〈0. 05） . After ventilation,PaO2,SaO2 were elevated significantly（ P〈0. 05） . Heart rate and respiratory rate decreased（ P〈0. 01） . Conclusion： Non-invasive positive pressure ventilation is capable to improve dyspnea and relieve clinical symptoms of ALVF.