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无创通气救治老年急性左心衰患者的临床价值 被引量:15

The Clinical Value of Noninvasive Ventilation in the Treatment of Elderly Patients with Acute Heart Failure
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摘要 目的:探讨老年急性左心衰患者在常规药物治疗的基础上,运用无创性双水平气道正压通气救治的临床价值。方法:对55例60岁以上的老年急性左心衰患者,经常规鼻导管吸氧及强心、利尿等药物治疗40 min后仍无效的,应用无创双水平气道正压通气治疗。观察治疗前后患者的症状、体征、血清B型利钠肽及动脉血氧分压、动脉血二氧化碳分压等指标变化情况。结果:经无创呼吸机治疗后,46例患者(83.6%)呼吸困难明显改善,双肺啰音减少,心率、呼吸、血清B型利钠肽下降,动脉血氧分压、动脉血氧饱和度升高,比较差异有统计学意义(P<0.05)。9例患者病情加重改为气管插管有创机械通气治疗,其中5例死亡。结论:针对药物治疗效果不佳的急性左心功能衰竭的老年患者,无创性双水平气道正压通气治疗可迅速提高动脉血氧含量、改善心功能、减轻肺水肿,减少了气管插管有创机械通气的使用及相关并发症,减轻了患者的痛苦,效果显著,是一种安全有效的急救方法。 Objective: To investigate the clinical value of noninvasive bi-level positive airway pressure (BiPAP) in the treatment of elderly patients with acute lefTheart failure on the basis of conventional drug treatment.Method: 55 elderly patients with acute lefTheart failure above 60 years old, after conventional nasal catheter oxygen and strong heart, diuresis drug treatment 40 min stilled invalid, then were treated with BIPAP. The symptoms and signs, serum brain natriuretic peptide (BNP) and partial pressure of oxygen in arterial blood (PaO2), partial pressure of carbon dioxide in arterial blood (PaCO2) and so on before and after the treatment of all patients were observed.Result: After the treatment with noninvasive ventilator,46 cases (83.6%) of dyspnea improved obviously, double lung sound decreased, heart rate (HR), respiratory (R), the BNP declined, PaO2, arterial oxygens aturation (SaO2) increased, the differences were statistically significant (P〈0.05). 9 patients due to illness were changed tracheal intubation mechanical ventilation treatment, 5 cases died.Conclusion: For the poor effect of drug treatment in elderly patients with acute lefTheart failure, BIPAP treatment can rapidly improve the arterial blood oxygen content, improve heart function, relieve edema, reduce the use of tracheal intubation invasive mechanical ventilation and related complications, reduce the patient’s pain and the effect is remarkable. It is a safe and effective method of first aid.
作者 王娟 高永刚
出处 《中国医学创新》 CAS 2015年第7期31-33,共3页 Medical Innovation of China
关键词 无创性双水平气道正压通气 急性左心衰 老年人 Noninvasive bi-level positive airway pressure Acute left heart failure Elderly people
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