无创呼吸机治疗急性重症左心功能衰竭合并Ⅱ型呼吸衰竭的临床效果

Clinical effect of noninvasive ventilator in treating acute severe left heart failure complicated with type Ⅱ respiratory failure

目的探讨无创呼吸机治疗急性重症左心功能衰竭合并Ⅱ型呼吸衰竭的临床效果。方法选取成都市天府新区人民医院2013年9月—2015年9月收治的急性重症左心功能衰竭合并Ⅱ型呼吸衰竭患者82例,随机将患者分为对照组与研究组,各41例。在常规治疗基础上,对照组予以持续正压通气治疗,研究组予以无创正压通气治疗,比较两组患者治疗前后血气分析指标[血氧分压(PaO_2)、血二氧化碳分压(PaCO_2)、酸碱度(p H值)]、心功能指标[左心室射血分数(LVEF)、每搏输出量(SV)及心肌做功指数(MPI)]及并发症发生情况。结果治疗前两组患者PaO_2、PaCO_2、p H值比较,差异无统计学意义(P>0.05);治疗后研究组患者PaO_2高于对照组,PaCO_2低于对照组,p H值小于对照组(P<0.05)。治疗前两组患者LVEF、SV、MPI比较,差异无统计学意义(P>0.05);治疗后研究组患者LVEF、SV高于对照组,MPI低于对照组(P<0.05)。两组患者均未发生严重并发症。结论无创呼吸机治疗急性重症左心功能衰竭合并Ⅱ型呼吸衰竭的临床效果确切,可有效改善患者血气分析指标与心功能。

Objective To study the clinical effect of noninvasive ventilator in treating acute severe left heart failure complicated with type Ⅱ respiratory failure. Methods A total of 82 cases of patients with acute severe left heart failure complicated with type Ⅱ respiratory failure were selected from September 2013 to September 2015 in People ＇s Hospital of Tianfu New District of Chengdu City,which were randomly divided into control group and study group,41 cases in each group. On the basis of routine treatment,control group was treated with continuous positive airway pressure,study group was treated with noninvasive positive airway pressure. The blood gas analysis indexes（ PaO2,PaCO2,pH value）,cardiac function indexes（ LVEF,SV,MPI） before and after treatment and the incidence of complications were compared between the two groups. Results Before treatment,no statistically significant differences of PaO2,PaCO2 or pH value was found between the two groups（ P〉0. 05）; after treatment,the study group of PaO2 was higher than control group,PaCO2 was lower than control group,pH value was smaller than control group（ P〈0. 05）. Before treatment,no statistically significant differences of LVEF,SV or MPI was found between the two groups（ P〉0. 05）; after treatment,the study group of LVEF,SV,MPI were higher than control group,MPI was lower than control group（ P〈0. 05）. There was no significant adverse reactions. Conclusion Noninvasive ventilator has an exactly clinical effect in treating acute severe left heart failure complicated with type Ⅱ respiratory failure,it can effectively improve blood gas analysis indexes and cardiac function.