无创正压通气在尿毒症合并急性左心衰竭患者血液透析中的应用体会

Noninvasive Positive Pressure Ventilation in Uremic Complicating Acute Left Heart Failure Patients with the Blood Dialysis Application Experience

目的:探讨无创正压通气(non-invasive positive pressure ventilation,NIPPV)在尿毒症合并急性左心衰竭患者血液透析中的作用。方法:尿毒症并发急性左心衰竭患者42例,随机分为治疗组17例,对照组25例。对照组仅进行常规透析等治疗,治疗组在常规透析等治疗的基础上加用无创正压通气。结果:治疗组有1例退出,只有16例的数据纳入统计。治疗组的透析时间、透析后心脏泵功能Killip分级情况均好于对照组。而透析后的平均动脉压、呼吸频率、心率以及入院后3d内死亡或放弃治疗情况在两组间无明显差异。结论:在尿毒症合并急性左心衰竭患者血液透析中应用NIPPV能提高临床效果。

Objective：To investigate the effect of NIPPV on uremic patients with acute left ventricular failure in hemo- dialysis. Methods： 42 uremia patients with acute left heart failure were randomly divided into treatment group of 17 ca- ses and control group of 25 cases. The control group had routine treatment. The treatment group had NIPPV besides routine treatment. Results： 1 case of treatment group quitted and 16 cases were counted. The duration of hemodialysis and cardiac pump function Killip class of treatment group were better than the control group. The mean arterial blood pressure, respiratory rate, heart rate after hemodialysis and the number of death or giving up in the 3 days after admis- sion were no significant difference between the two groups. Conclusion.. Treat the uremic patients with acute left ventric- ular failure with NIPPV in hemodialysis could get a better effect.