无创双水平气道正压通气治疗重度急性左心衰竭

OBSERVATION OF NONINVASIVE BI-LEVEL POSITIVE PRESSURE VENTILATION FOR THE TREATMENT OF SEVERE ACUTE LEFT HEART FAILURE

目的 观察无创双水平道正压通气对重度急性左心衰竭的疗效。方法 选择16例次经常规治疗方法无效的重度急性左心衰竭所致的严重低氧血症患者，进行无创双水平气道正压通气，并行临床症状、体征、有创动脉血压、血气分析等指标监测。结果 16例次重度急性左心衰患者抢救成功15例次，死亡1例，抢救成功率93.7％。治疗2h后患者生命体征稳定，氧分压和氧饱和度明显提高，通气前后比较P＜0.01。结论 无创双水平气道正压通气，通过调节压力支持和呼气末正压水平，可改善左心功能，降低肺间质和肺光的渗出，改善通气血流比率，有利于气体交换，从而提高动脉氧分压和氧饱和度。

Objective\ To observe noninvasive bi-level positive pressure ventilation for the treatment of severe acute left heart failure.Methods\ 16 patients with hypoxemia due to severe acute heart failure with non-reaction to the normal treatment received noninvasive bi-level positive pressure ventilation and were monitored under clinical symptoms,signs,traumatic arterial blood pressure and blood gas analysis.Results\ 16 patients survived and 1 died with success rate of 93.7%.After two-hour therapy,the patients vital signs were stable and PaO 2 and SaO 2 went up.Conclusion\ Noninvasive bi-level positive pressure ventilation can decrease the pulmonary interstitial and alveolar edema,improve left heart function through adjusting pressure support and end-respiratory positive pressure.It also improve the rate of V/Q,facilitate gas exchange,and promote PaO 2 and SaO 2.