呼吸机治疗急性心力衰竭合并呼吸衰竭的疗效观察

The curative effect of EICU breathing machine in the treatment of acute heart failure complicated with respiratory failure

目的：探讨急诊 ICU 中应用呼吸机治疗急性心力衰竭合并呼吸衰竭的疗效。方法选取急诊ICU 收治的急性心力衰竭合并呼吸衰竭患者共110例，按照数字表法随机分为对照组和观察组，给予对照组患者常规治疗，观察组患者在常规治疗的基础上再给予呼吸机治疗，比较两组患者的治疗疗效。结果两组患者治疗前在 PaO2、PaCO2、PH 以及 SaO2方面比较，差异无统计学意义（P ＞0．05）；观察组患者治疗后 PaO2、pH、SaO2分别为（11．41±2．25）kPa、（7．42±0．19）、（97．11±2．17）％，显著高于对照组，PaCO2为（5．21±0．22）kPa，显著低于对照组，差异有统计学意义（t ＝2．501，P ＝0．014；t ＝2．598，P ＝0．011；t ＝2．855，P ＝0．005；t ＝－2．691，P ＝0．008）；观察组患者治疗后血浆脑钠肽为（472．32±298．06）pg／L，显著低于对照组，差异有统计学意义（t ＝－2．263，P ＝0．026）。结论急诊 ICU 中应用呼吸机治疗急性心力衰竭合并呼吸衰竭临床效果显著，有效改善患者临床症状，临床上值得进一步推广应用。

Objective To explore the curative effect of breathing machine in the treatment of acute heart failure complicated with respiratory failure.Methods 1 1 0 patients with acute heart failure and respiratory failure in emergency ICU of our hospital were selected,they were randomly divided into control group and observation group.The control group received routine therapy,the observation group was given breathing machine on the basis of routine therapy.The treatment efficacy of the two groups was compared.Results Before treatment,PaO2 ,PaCO2 ,PH and SaO2 between the two groups had no obvious differences （P ＆gt;0.05 ）.After treatment,PaO2 ,PH and SaO2 in the observation group were （1 1 .41 ±2.25）kPa,（7.42 ±0.1 9）,（97.1 1 ±2.1 7）%,which were significantly higher than those in the control group,PaCO2 was （5.21 ±0.22）kPa,which was significantly lower than the that of the control group,the differences were statistically significant （t =2.501 ,P =0.01 4;t =2.598,P =0.01 1 ;t =2.855,P =0.005;t =-2.691 ,P =0.008）.The level of sernm brain natriuretie peptide of the observation group[（472.32 ± 298.06）pg/L]was significantly lower than that of the control group,the difference was statistically significant（t =-2.263,P 〈0.05）.Conclusion The clinical effect of breathing machine EICU in treatment of acute heart failure complicated with respiratory failure is remarkable,and can effectively improve the clinical symptoms,and is worth further clinical application.