有创-无创序贯机械通气辅助治疗急性左心衰竭合并呼吸衰竭的疗效

Effect of Invasive-Noninvasive Sequential Mechanical Ventilation in Treatment of Acute Left Heart Failure Complicated with Respiratory Failure

目的观察有创-无创序贯机械通气治疗急性左心衰竭(acute left heart failure,ALHF)合并呼吸衰竭(respiratory failure,RF)的疗效。方法选取2015年6月至2018年3月吉林市人民医院收治的72例ALHF合并RF患者,以随机数字表法分为对照组和观察组,各36例。对照组行有创机械通气,观察组行有创-无创序贯机械通气。比较两组患者的肺炎发生率、14天内撤机成功率、院内死亡率及血气分析指标。结果观察组患者呼吸机相关性肺炎发生率较对照组低,撤机成功率较对照组高(P<0.05),两组院内死亡率差异无统计学意义(P>0.05);观察组治疗后PaO2、PaCO2、PH均优于对照组(P<0.05)。结论ALHF合并RF患者应用有创-无创序贯机械通气辅助治疗可显著提高疗效,明显改善血气分析指标。

Objective To observe the efficacy of sequential invasive-noninvasive mechanical ventilation in the treatment of acute left heart failure(ALHF)with respiratory failure(RF).Methods From June 2015 to March 2018,72 patients with ALHF combined with RF were randomly divided into control group and observation group(36 cases).The control group was treated with invasive mechanical ventilation and the observation group was treated with invasive-non-invasive sequential mechanical ventilation.The incidence of pneumonia,success rate of ventilator withdrawal within 14 days,hospital mortality and blood gas analysis were compared between the two groups.Results There was a significant difference between the two groups in the incidence of ventilatorassociated pneumonia and the success rate of ventilator withdrawal within 14 d(P<0.05).There was no significant difference in mortality between the two groups(P>0.05).The indexes of PaO2,PaCO2 and PH in the blood gas analysis of the observation group were better than those in the control group after treatment(P<0.05).Conclusion The effect of sequential mechanical ventilation treatment in LHF complicated with RF patients is accurate,which can improve blood gas analysis indicators.