ACS合并低氧血症患者NIMV治疗的应用时机

The Application Time of NIMV Treatment in ACS Patients with Hypoxaemia

目的探讨急性冠脉综合征合并低氧血症的患者应用无创机械通气治疗进行干预的时机.方法2014年7月至2015年7月在昆明医科大学附属延安医院诊断为急性冠脉综合征合并低氧血症的患者46例,使用面罩供氧后,脉搏血氧饱和度仍然持续下降至≤90%时,给予经口鼻面罩进行双水平气道正压通气(Bi Level)治疗,观察机械通气前和通气2 h后呼吸频率、脉搏血氧饱和度、动脉血气分析等指标的变化.结果 46例急性冠脉综合征合并低氧血症的患者,给予无创机械通气治疗2 h后,呼吸频率、脉搏血氧饱和度、动脉血氧分压均有明显改善,临床症状缓解明显.结论急性冠脉综合征合并低氧血症的患者,在使用面罩供氧后,脉搏血氧饱和度仍然持续下降至≤90%,出现呼吸衰竭时,开始应用无创机械通气治疗,能够安全、迅速地纠正低氧血症和呼吸衰竭.

Objective To observe and discuss the application time with non- invasive mechanical ventilation in acute coronary syndrome patients with hypoxemia. Methods We selected 46 cases of ACS patients with hypoxaemia who were diagnosed in our hospital from July 2014 ~July 2015, After using the mask oxygen, bi- level positive airway pressure ventilation through oronasal mask was given to these patients when pulse oxygen saturation continued to decline to ≤90%. Then we observed the changes of breathing rate, pulse oxygen saturation and arterial blood gas analysis and other indicators before and after 2 hours of Mechanical ventilation and ventilation. Results Respiratory rate, pulse oxygen saturation, arterial partial pressure of oxygen and clinical symptoms were improved after 2 hours in 46 cases of ACS patients with hypoxaemia who were treated by Non- invasive mechanical ventilation.Conclusion Application of non- invasive mechanical ventilation in the treatment, can safely and quickly correct hypoxemia and respiratory failure in ACS patients with hypoxaemia whose pulse oxygen saturation continued to decline to ≤90% after using the mask oxygen.