双水平正压通气在急性左心衰竭中的疗效观察

Efficacy of noninvasive mechanical bi-level positive airway pressure ventilation in the treatment of acute left heart failure

目的:总结46例急性左心衰竭患者应用双水平正压通气(BiPAP)的疗效。方法:观察无创通气治疗前后的平均动脉压(MBP)、血氧饱和度(SaO2)、呼吸频率(RR)、心率(HR)、左室射血分数(LVEF)、左室舒张末内径(LVEDD)、左房内径(LVD)、血脑钠肽(BNP)等变化。结果:治疗2 h后MBP、SaO2、RR、HR、LVD及BNP均较治疗前显著改善(P<0.05、P<0.01),12 h后LVEF升高,LVEDD缩小(P<0.05)。结论:应用双水平正压通气治疗急性左心衰竭能快速改善患者的呼吸功能,并能减轻心肌耗氧,降低心脏负荷,可作为急性心力衰竭的综合治疗手段之一。

Objective：To evaluate the efficacy of noninvasive mask bi-level positive airway pressure（BiPAP） ventilation in 46 patients with acute left heart failure.Methods：The changes of MBP,SaO2,RR,HR,LVEF,LVEDD,LVD and BNP before and after the use of BiPAP were observed.Results：After 2 hours BiPAP ventilation,notable improvement had been found in MBP,SaO2,RR,HR,LVD and BNP（P0.05,P0.01）,after 12 hours ventilation,improvement had been found in LVEF and reducement in LVEDD（P0.05）.Conclusion：Noninvasive BiPAP mask ventilation could improve respiratory function,reduce myocardial oxygen consumption and cardiac load.It is one of the combined therapy methods in treating acute left heart failure.