无创正压通气治疗急性左心衰82例临床观察

Treatment of acute left heart failure with non-invasive positive pressure ventilation

目的探讨无创正压通气(Non-invasive positive pressure ventilation,NIPPV)模式治疗急性左心衰(Acute left heart failure,ALHF)的临床疗效。方法 2例ALHF患者在常规治疗的基础上加用NIPPV,观察并记录上机前0.5h和上机后1h和2h的心率(HR)、呼吸频率(RR)、平均动脉压(MAP)、血氧饱和度(SaO2)以及血气分析参数等临床指标,并比较通气前后各项指标的差异。结果 NIPPV 1h后,患者HR、RR、MAP、SaO2、PaO2、PaCO2明显好转,与治疗前比较差异有统计学意义(P<0.05);NIPPV 2h后上述指标进一步好转(P<0.01)。82例患者中有10例不能耐受NIPPV,其余72例NIPPV疗效满意,有效率为87.8%。结论早期使用NIPPV能迅速改善心肺功能,是抢救ALHF的一种安全有效方法。

Objective To investigate the clinical effects of non-invasive positive pressure ventilation（NIPPV） in the treatment of acute left heart failure（ALHF）.Methods 82 patients with ALHF received NIPPV based on conventional treatments.The clinical indicators such as heart rate,respiratory rate,arterial oxygen saturation,blood gas analysis parameters were gathered analyzed at 1 h,2 h of therapy.Results After 1 h NIPPV,The clinical indicators such as heart rate,respiratory rate,arterial oxygen saturation,partial pressure of oxygen in artery,partial pressure of carbon dioxide in artery had bettered significantly（P0.05）;after 2h NIPPV,the clinical indicators had bettered more significantly（P0.01）.Of all 82 patients,10 patients couldn＇t tolerance NIPPV,72 patients received content curative effect.Conclusion Based on conventional treatments,NIPPV in the earlier period can better cardiac and lung function,NIPPV is a safe and effective method in the treatment of ALHF.