机械通气对高龄重度急性左心衰竭合并呼吸衰竭患者的治疗效果

Therapeutic effect of mechanical ventilation on elderly patients with severe acute left heart failure complicated with respiratory failure

目的探讨机械通气治疗高龄重度急性左心衰竭合并呼吸衰竭的临床效果。方法回顾2013年3月至2017年12月在我院接受治疗的145例高龄重度急性左心衰竭合并呼吸衰竭患者的临床资料。根据呼吸衰竭程度不同分级,其中62例合并Ⅰ型呼吸衰竭,83例合并Ⅱ型呼吸衰竭,患者均行机械通气治疗。比较两组的治疗效果。结果合并Ⅰ呼吸衰竭患者的病情好转率、病死率均优于合并Ⅱ型呼吸衰竭患者(P<0.05)。通气后,两组的PaO_2、PaCO_2水平均显著改善(P<0.05),但两组间无显著差异(P>0.05)。合并Ⅰ型呼吸衰竭患者在通气过程中的并发症总发生率低于合并Ⅱ型呼吸衰竭患者(P<0.05)。结论高龄重度急性左心衰竭合并呼吸衰竭可行机械通气治疗,而合并呼吸衰竭程度越重,治疗难度越大。因此,临床对于该类患者应做到早诊断、早治疗。

Objective To investigate the clinical effect of mechanical ventilation in the treatment of elderly patients with severe acute left heart failure complicated with respiratory failure.Methods The clinical data of 145 elderly patients with severe acute left heart failure complicated with respiratory failure treated in our hospital from March 2013 to December 2017 were reviewed.According to the different grades of respiratory failure,there were 62 cases complicated with typeⅠrespiratory failure and 83 cases complicated with typeⅡrespiratory failure.All patients were treated with mechanical ventilation.The therapeutic effects of the two groups were compared.Results The improvement rate and mortality rate of patients complicated with typeⅠrespiratory failure were better than those of patients complicated with typeⅡrespiratory failure(P<0.05).After ventilation,the levels of PaO2 and PaCO2 in both groups improved(P<0.05),but there were no significant differences between the two groups(P>0.05).The total incidence of complications during ventilation in patients complicated complicated with typeⅠrespiratory failure was lower than that in patients complicated with typeⅡrespiratory failure(P<0.05).Conclusion Mechanical ventilation is feasible for elderly patients with severe acute left heart failure complicated with respiratory failure.With the severity of complicated with respiratory failure,the treatment is more difficult.Therefore,early diagnosis and treatment should be done for this kind of patients in clinic.