有创机械通气联合咪达唑仑在老年急性左心衰患者中的治疗观察

Invasive Mechanical Ventilation Combined with Midazolam in Elderly Patients with Acute Heart Failure

目的观察并分析48例有创机械通气联合咪达唑仑注射液在抢救老年急性重症左心衰的疗效。方法采集并分析2008年6月～2010年4月中山市三乡医院重症监护室收治的48例老年急性重症左心衰患者,在常规抗心衰治疗无效时予以有创机械通气联合咪达唑仑注射液镇静治疗,观察治疗前后的临床症状及HR（心率）、R（呼吸频率）、MBP（平均动脉压）、尿量等及血气分析：pH值（动脉血PH值）、PO2（动脉血氧分压）、PCO2（动脉血二氧化碳分压）、HCO3-（动脉血碳酸氢根）等指标的变化。结果 48例重度心衰患者患者除6例在抢救过程中死亡外,其余42例症状均得到明显的缓解,有效缓解率为87.5%。在治疗前后监测体征及血气分析的各项检测指标变化均P〈0.01,有统计学差异。结论在老年急性重度左心衰患者的抢救中,尽早使用有创机械通气联合咪达唑仑可以显著提高抢救的成功率。

Objective The clinical effect of invasive mechanical ventilation combined with Midasolam were analysed in 48 elderly cases with acute left heart failure. Methods All 48 patients admitted in Sanxiang hospital from June 2008 to April 2010. Invasive mechanical ventilation combined with Midazolam was performed in 48 patients with acute severe left heart failure in which the conventional treatment is not valid,the changes of clinical symptoms and other indicators were observed as follows：HR （heart rate）, R（breathing）, MBP （mean arterial pressure）, the amount of urine, and blood gas analysis： pH （arterial blood pH）, PO2 （arterial oxygen tension）, PCO2 （arterial blood carbon dioxide partial pressure）, HCO3-（arterial bicarbonate）. Results 48 cases of severe heart failure patients subject to 6 cases in rescuing dead, 42 eases symptoms are apparent ease, effectively alleviate 87.5%. In the treatment monitoring of vital signs and blood gas analysis for the detection of targets change P〈0.01. Conclusion In elderly patients with acute severe left heart failure,using invasive mechanical ventilation combined with Midazolam as soon as possible can dramatically improve the success rate of treatment.