无创正压通气在心力衰竭治疗中的应用进展

Application progress of noninvasive positive pressure ventilation in treatment of heart failure

心力衰竭是各种心血管疾病晚期的临床综合征,目前心力衰竭的治疗除指南推荐的个体化最佳药物方案外,还有心脏再同步治疗、左心室辅助装置和心脏移植等先进治疗手段,但心力衰竭人群的总体治疗效果仍然较差。改善住院疗效,缩短住院时间,提高生活质量,降低反复住院频率等问题一直是临床关注的焦点。无创正压通气(NIPPV)作为一种非药物、非侵入性措施治疗心力衰竭越来越受到临床重视。除最新心力衰竭指南推荐NIPPV用于治疗合并呼吸衰竭、呼吸窘迫的急性左心力衰竭患者外,NIPPV在慢性心力衰竭加重期的治疗中也发挥积极作用,尤其是对住院期间控制患者心力衰竭症状,改善患者住院期间生活质量,缩短心力衰竭住院时间等方面。本文对NIPPV在心力衰竭治疗中的作用机制、应用进展及使用注意事项等进行综述。

The heart failure is a late clinical syndrome of various cardiovascular diseases.In addition to the best individualized medication regimen in the heart failure treatment recommended by the guidelines,the advance treatment means such the cardiac resynchronization therapy,left ventricular assist device and cardiac transplantation,but the treatment effect of the whole heart failure population is still poor.The problems such as improving the hospitalization efficacy,shortening the hospitalization stay,improving the quality of life and reducing the frequency of repeated hospitalization are always the focuses of clinical attention.As a non-invasive and non-drug measure for treating heart failure,non-invasive positive pressure ventilation(NIPPV)has been received more and more clinical attention.In addition NIPPV is recommended by the latest guideline to treat acute left heart heart failure complicating respiratory failure and respiratory distress,NIPPY also plays an active effect in the treatment of the aggravation stage of chronic heart failure,especially in the aspects of controlling the heart failure symptoms of the patients during hospitalization,improving the life quality during hospitalization and shortening the heart failure hospitalization time.This article reviews the mechanism,application progress and the use cautions of the NIPPV in the treatment of heart failure.