急诊科应用呼吸机治疗急性重症心力衰竭的临床研究

Clinical Study of Acute Severe Heart Failure with Ventilator in the Emergency Department

目的分析急诊科在急性重症心力衰竭患者中应用呼吸机的临床研究。方法选取2014年1月-2015年11月期间在郑州市第九人民医院急诊科就诊的急性重症心力衰竭患者87例,按照随机分组对照原则将其分成研究组和对照组,其中对照组37例予以常规治疗,针对救治1~2小时后未见好转的患者予以呼吸机治疗,研究组50例早期即在常规处理的基础上联合呼吸机治疗。统计分析组间治疗前后相关指标(HR、RR、MBP及PaO2)变化、临床症状消失时间及撤机时间和住院时间,并观察两组患者治疗后心功能分级情况以及临床有效率和气管插管率。结果治疗后,研究组HR、RR及MBP均明显低于对照组,PaO2水平明显高于对照组(P<0.05)。同时,研究组肺部啰音、发绀及意识障碍症状缓解时间及撤机时间和住院时间均比对照组短(P<0.05)。治疗后研究组心功能改善明显优于对照组,研究组气管插管率较对照组低,差异均有统计学意义(P<0.05);研究组临床总有效率高于对照组(P<0.05)。结论针对急诊科急性重症心力衰竭患者,在常规处理的基础上早期联合呼吸机治疗,能够有效缓解症状、改善心功能,可减少气管插管,可供临床参考。

OBJECTIVE To analyze the clinical study of ventilator in patients with acute severe heart failure in emergencydepartment. METHODS 87 patients with acute severe heart failure who were admitted to the emergency department ofour hospital from January 2014 to November 2015 were enrolled. The patients were divided into study group and controlgroup according to the randomized controlled principle. 37 patients in the control group received routine treatment. Inthe treatment group, 50 patients were treated with ventilator on the basis of routine treatment. Statistical analysis ofchanges in related indicators(HR, RR, MBP, and PaO2), disappearance of clinical symptoms, time of weaning, andlength of hospitalization, and observation of cardiac function grading and clinical effectiveness after treatment Trachealintubation rate. RESULTS After treatment, the HR, RR and MBP of the study group were significantly lower than the con-trol group, and the PaO2 level was significantly higher than the control group(P<0.05). At the same time, the studygroup’s lung voice, cyanosis and disturbance of consciousness symptoms and the time of weaning and hospital stay wereshorter than the control group(P<0.05). After treatment, the improvement of cardiac function in the study group was sig-nificantly better than the control group. The tracheal intubation rate of the study group was lower than that of the controlgroup, and the difference was statistically significant(P<0.05). The total effective rate of the study group was higherthan the control group(P<0.05).CONCLUSION For patients with acute severe heart failure in the emergency depart-ment, early combined with ventilator treatment on the basis of routine treatment can effectively relieve symptoms, im-prove cardiac function, and reduce tracheal intubation for clinical reference.