无创正压通气在急性难治性左心衰治疗中的临床研究

Noninvasive positive pressure ventilation in the treatment of acute intractable left heart failure in clinical research

目的:观察无创正压通气(NIPPV)在急性难治性左心衰竭(ALVF)治疗的临床疗效。方法:ALVF患者72例,随机分为NIPPV治疗组和对照组各36例。对照组行强心、扩冠、利尿等抗心力衰竭治疗,治疗组在对照组的基础上加用BiPAP无创通气。观察两组患者治疗前和治疗后2、4、6h心率、呼吸、血压、血气分析的变化,及24h病情好转率、气管插管率、死亡率。结果:①治疗组任何时段的各项指标均较治疗前改善明显(P<0.01),对照组6h内仅有HR减慢较治疗前明显(P<0.01),治疗后治疗组任何时段的各项指标均较对照组相应时段的各项指标改善明显(P<0.01);②与对照组比较,治疗组治疗后24h好转率高(P<0.05)、气管插管率低(P<0.05)及死亡率低。结论:在常规抗心力衰竭治疗基础上加用BiPAP无创正压通气治疗ALVF疗效显著,可降低病死率。

Objective：Observe noninvasive positive pressure ventilation（NIPPV） in patients with acute intractable left heart.Methods：ALVF 72 patients were randomly divided into the treatment group and control group NIPPV 36 cases.The control group did strong heart,diuresis,expanding coronary antidepressants hf treatment,the treatment group in the control group on the basis of noninvasive ventilation BiPAP add with.Observe both groups of patients before treatment and after treatment 2,4,6 hours,heart rate,blood pressure,blood gas analysis of change,and 24 hours illness recovery,tracheal intubation rate and mortality.Results：①The treatment group any time of each index all relatively before treatment improved significantly（P0.01）,the control group 6 hours within a before treatment only HR slows significantly（P0.01）,the treatment group any time all indexes than control group corresponding period the indicators of improved significantly（P0.01）;②compared with controls,the treatment group 24 hours recovery after the treatment of high（P0.05）,tracheal intubation low rate（P0.05） and mortality rates low.Conclusion：In conventional anti hf treatment on the basis of add with BiPAP noninvasive positive airway pressure treatment ALVF curative effect is distinct,can reduce mortality.