压力支持通气与成比例辅助无创通气治疗重症心力衰竭的效果对比

A comparative study on the effect of pressure support ventilation and proportional assist ventilation in treatment of sever heart failure

目的观察压力支持通气(PSV)和成比例辅助通气(PAV)治疗重症心力衰竭的临床效果。方法将30例经常规药物治疗无效的重症心力衰竭患者随机分为PSV组和PAV组,分别予PSV和PAV无创正压通气,观察治疗前后患者心率(HR)、呼吸频率(RR)、平均动脉压(MAP)、动脉血氧分压(Pa O2)、氧合指数(Pa O2/Fi O2)、视觉模拟评分(VAS)、辅助呼吸肌动用评分、气道峰压等指标的变化。结果两组HR、RR、MAP均较治疗前明显下降,Pa O2和Pa O2/Fi O2均较治疗前明显提高,差异有统计学意义(P<0.05);但治疗后两组间比较,差异无统计学意义(P>0.05)。PAV组气道峰压低于PSV组,呼吸舒适度(包括VAS评分、辅助呼吸肌动用评分)低于PSV组,差异有统计学意义(P<0.05)。结论 PSV、PAV能改善重症心力衰竭患者的氧合功能,缓解呼吸困难;PSV与PAV的疗效相仿,PAV的同步性、舒适性优于PSV。

Objective To compare the therapeutic effect of pressure support ventilation（PSV） and proportional assist ventilation（PAV） in treatment of sever heart failure. Methods 30 patients with severe congestive heart failure who exhibited poor response to conventional therapy were randomly divided into PSV group and PAV group,15 cases in each group,were treated with PSV and PAV respectively.The HR,RR,MAP,PaO2,PaO2/Fi O2,VAS,auxiliary respiratory muscles score and airway pressure of two groups was recorded and compared. Results After treatment,the two groups of HR,RR and MAP was decreased compared with before treatment,PaO2 and PaO2/FiO2 was increased compared with before treatment,the difference was significant（P〈0.05）;but there was no significant difference between the two groups（P〉0.05）.The peak airway pressure and the index of degree of comfort（VAS and auxiliary respiratory muscles score） in PAV group was lower than that in PSV group,the difference was significant（P〈0.05）. Conclusion PSV and PAV can improve the oxygenation and relief of dyspnea.PSV and PAV has the similar effect,but the synchronization and comfort of PAV is better than that of PSV.