无创正压机械通气在急性心肌梗死院前急救中应用的意义分析

Analysis of the Significance of the Application of Noninvasive Positive Pressure Ventilation in Pre-Hospital Emergency of Acute Myocardial Infarction

目的探讨无创正压机械通气在急性心肌梗死院前急救中应用的临床意义。方法选取2009年8月至2012年12月期间我院急诊接诊并行院前急救的急性心肌梗死患者61例,随机分为两组。其中对照组28例,观察组33例,使其有可比性。对照组患者给予常规治疗,观察组患者在常规治疗的基础上实施无创正压机械通气治疗。对两组患者的心率、呼吸频率、血压进行监测,估算两组患者的心肌耗氧量,并统计两组患者的治疗转归。结果经过治疗,两组患者的心率、呼吸、收缩压以及心肌耗氧量与治疗前相比均有所降低,且观察组患者降低更为明显(P<0.05);观察组患者气管插管率、死亡率以及住院时间均明显少于对照组,两组比较差异有统计学意义(P<0.05)。结论对急性心肌梗死患者在院前急救阶段实施无创正压通气可以有效改善患者的治疗效果和预后,缩短患者的治疗时间,可以作为急性心肌梗死院前急救的重要组成部分在临床进行推广和应用。

Objective To investigate the clinical significance of the application of noninvasive positive pressure ventilation in pre-hospital emergency of acute myocardial infarction. Methods 61 cases of emergency admissions parallel pre-hospital care in patients with acute myocardial infarction in our hospital were chosen and randomly divided into the control group （n = 28） and the observation group （n = 33）, and the two groups were comparable. The patients in the control group received the conventional therapy, and the patients in the observation group received the noninvasive positive pressure ventilation for treatment based on the conventional therapy. The heart rates, respiratory rate, blood pressure of two groups were detected and monitored, the myocardial oxygen consumption was estimated, and the treatment outcomes for patients were taken for statistics. Results After treatment, the heart rates, respiration, systolic blood pressure and myocardial oxygen consumption were reduced compared with those before the treatment in both groups, but the observation group reduced more significantly compared with the control group （P 〈0.05）. The intubation rate, mortality and hospitalization time in the observation group were significantly fewer than those of the control group （P 〈0.05）. Conclusions The implementation of noninvasive positive pressure ventilation for patients with acute myocardial infarction in the pre-hospital emergency phase can effectively improve outcomes and prognosis, shorten the duration of treatment, which can be used as an important part of the pre-hospital emergency care of acute myocardial infarction for clinical promotion and application.