无创机械性通气对于急性心力衰竭并呼吸衰竭的临床效果及对其血流动力学和血氧状态的影响及观察与分析

The clinical effects of noninvasive mechanical ventilation on acute heart failure plus respiratory failure and hemodynamics and blood oxygen status

目的:本研究旨在观察和分析Bi PAP无创正压通气(NIPPV)对于急性心力衰竭并呼吸衰竭的临床效果及血流动力学和血氧状态的影响。方法:选取2011年1月-2014年12月在我院ICU住院治疗的急性心力衰竭合并呼吸衰竭的患者360例,将其随机分为两组。对照组(n=180)常规抗心力衰竭、呼吸衰竭药物治疗;观察组(n=180)在常规抗心力衰竭、呼吸衰竭的药物治疗的基础上采用Bi PAP呼吸机进行无创通气治疗。记录治疗前后的症状、体征、血流动力学以及血氧状态。结果:观察组的治疗总有效率、显效率均明显高于对照组(P<0.05),两组患者治疗前HR、RR、SBP、DBP以及PCO2均无显著差异(均P>0.05),治疗后治疗组的HR、RR、SBP、DBP以及PCO2均明显低于对照组(P<0.05),与对照组比较,差异有统计学意义(P<0.05);另外,两组患者治疗前后p H值无明显改变(P>0.05);观察组治疗后的SPO2、SJVO2改善程度明显好于对照组,差异具有统计学意义(P<0.01)。结论:与传统药物治疗相比较,无创正压机械通气可以明显降低患者的病死率,采用Bi PAP无创通气可明显改善心功能和呼吸功能,提高AHF合并RF的治疗显效率和治疗总有效率,是一种快速安全有效的抢救措施,值得在临床中推广。

Objective:To observe and analyze the clinical effects of BiPAP noninvasive positive pressure ventilation(NIPPV)on acute heart failure and respiratory failure,as well as on hemodynamics and blood oxygen status.Methods:A total of 360 patients with acute heart failure combined with respiratory failure in ICU of our hospital from January 2011 to December 2014 were selected and randomly divided into two groups.The control group(n=180)received routine anti-heart failure and respiratory failure drug therapy;The observation group(n=180)received BiPAP ventilator for non-invasive ventilation more.The symptoms,signs,hemodynamics and blood oxygen status were recorded before and after treatment.Results:The total efficiency and efficiency in the observation group were significantly higher than that in the control group(P<0.05).There were no significant differences in HR,RR,SBP,DBP,and PCO2 in the two groups before treatment(P>0.05).After treatment,HR,RR,SBP,DBP and PCO2 in the treatment group were all significantly lower than the control group,and the difference was statistically significant(P<0.05).Besides,The pH value in two groups was not significantly changed before and after treatment(P>0.05);The improvement of SPO2 and SJVO2 after treatment in the treatment group was significantly better than the control group,and the difference was statistically significant(P<0.01).Conclusion:Compared with conventional drug treatment,noninvasive positive pressure mechanical ventilation could obviously reduce the mortality of patients,using BiPAP noninvasive ventilation could significantly improve cardiac function and respiratory function,improve the merger of AHF RF significant efficiency and total treatment effectiveness,which was a safe and effective rescue measures and was worth popularizing clinically.