无创正压通气在治疗急性左心衰竭患者中的应用观察

Application of Noninvasive Positive Pressure Ventilation in Patients with Acute Left Heart Failure

目的探讨无创正压通气(NPPV)在治疗急性左心衰竭患者中的临床效果。方法将2013年9月-2014年7月收治的20例急性左心衰竭患者随机分为治疗组和对照组,每组各10例。两组患者均采用常规镇静、强心、利尿、扩血管等药物对症治疗,治疗组同时采用早期NPPV。观察两组患者治疗前以及治疗2 h后p H值、动脉血二氧化碳分压(Pa CO2)、动脉血氧分压(Pa O2)、心率(HR)、呼吸(R),入住重症监护病房(ICU)时间,有创通气时间,机械通气总时间和治疗成功例数。结果对照组治疗2 h后Pa O2(67.0±8.5)mm Hg(1 mm Hg=0.133 k Pa)、HR(124±10)次/min、R(34±4)次/min,入住ICU时间(6.0±1.1)d、有创通气时间(32±3.1)h、机械通气总时间(32.0±3.1)h;治疗组治疗2 h后Pa O2(82.3±8.9)mm Hg、HR(98±11)次/min、R(24±4)次/min,入住ICU时间(4.0±0.8)d、有创通气时间(16.0±1.3)h、机械通气总时间(26.0±1.8)h。两组患者各指标比较,差异均有统计学意义(P<0.05)。结论急性左心衰患竭者早期NPPV,对迅速缓解临床症状、降低医疗费用具有重要意义。

Objective To investigate the ef ects of noninvasive positive pressure ventilation（NPPV） on patients with acute let heart failure.Methods Twenty patients with acute let heart failure diagnosed between September 2013 and July 2014 were randomized into treatment group（n=10） and control group（n=10）.Both groups used conventional sedations,diuretics and drugs that strengthened the heart and dilated the vessels,while early use of NPPV was applied in the experimental group.Arterial blood gas analysis [p H value,pressure of arterial carbon dioxide（Pa CO2）,and pressure of arterial oxygen（Pa O2）],heart rate（HR）,respiration,duration of Intensive Care Unit（ICU） stay and invasive mechanical ventilation,duration of overall mechanical ventilation,and success case numbers before and two hours at er treatment were observed and analyzed.Results For the control group,two hours at er treatment,Pa O2 was（67.0±8.5） mm Hg（1 mm Hg=0.133 k Pa）,HR was（124±10） times/min,Respiration was（34±4） times/min,the duration of ICU stay was（6.0±1.1） days,invasive ventilation was for（32.0±3.1） hours,and the total time of mechanical ventilation was（32.0±3.1） hours.Those indexes for the treatment group two hours at er treatment were： Pa O2,（82.3±8.9） mm Hg; HR,（98±11） times/min; respiration,（24±4） times/min; the duration of ICU stay,（4.0±0.8） days; invasive ventilation time,（16.0±1.3） hours; the total time of mechanical ventilation,（26.0±1.8） hours.All the dif erences for each index between the two groups were statistically signii cant（P〈 0.05）.Conclusion Early application of NPPV can rapidly relieve clinical symptoms and reduce the medical cost for patients with acute let heart failure.