无创正压通气联合小剂量米力农对重症肺源性心脏病心力衰竭伴Ⅱ型呼吸衰竭患者预后的影响

Effect of noninvasive positive pressure ventilation combined with low dose milrinone on the prognosis of patients with severe pulmonary heart disease heart failure with typeⅡrespiratory failure

目的分析无创正压通气联合小剂量米力农对重症肺源性心脏病(以下简称肺心病)心力衰竭伴Ⅱ型呼吸衰竭患者预后的影响。方法选取2018年7月至2020年3月我院收治的108例重症肺心病心力衰竭伴Ⅱ型呼吸衰竭患者作为研究对象,按照随机数字表法将其分为研究组与对照组,各54例。研究组给予无创正压通气联合小剂量米力农治疗,对照组给予无创正压通气联合常规药物治疗。比较两组的临床疗效、心功能指标、肺通气功能指标及不良反应发生情况。结果研究组治疗总有效率明显高于对照组(P<0.05)。治疗7 d后,两组LVEF均较治疗前显著升高,cTnI、NT-proBNP水平均较治疗前显著降低,且研究组优于对照组(P<0.05)。治疗7 d后,两组MVV、VA均较治疗前显著升高,且研究组高于对照组(P<0.05)。研究组头痛、低血压、心动过速发生率略高于对照组,但差异无统计学意义(P>0.05)。结论无创正压通气联合小剂量米力农治疗重症肺心病心力衰竭伴Ⅱ型呼吸衰竭患者的效果显著,可有效改善患者的心功能及肺通气功能。

Objective To analyze the effect of noninvasive positive pressure ventilation combined with low dose milrinone on the prognosis of patients with severe pulmonary heart disease(here in after referred to as cor-pulmonale)heart failure with typeⅡrespiratory failure.Methods A total of 108 patients with severe cor-pulmonale heart failure with typeⅡrespiratory failure admitted in our hospital from July 2018 to March 2020 were selected as the research objects,and the patients were divided into study group and control group according to random number table method,with 54 cases in each group.The study group was treated with noninvasive positive pressure ventilation combined with low dose milrinone,while the control group was treated with noninvasive positive pressure ventilation combined with conventional drugs.The clinical efficacy,cardiac function index,pulmonary ventilation function index and adverse reactions were compared between the two groups.Results The total effective rate of treatment in the study group was significantly higher than that in the control group(P<0.05).After 7 d of treatment,LVEF in both groups were significantly higher than that before treatment,and cTnI and NT-proBNP levels were significantly lower than those before treatment,and those in the study group were better than the control group(P<0.05).After 7 d of treatment,MVV and VA in both groups were significantly higher than those before treatment,and those in the study group were higher than the control group(P<0.05).The incidences of headache,hypotension and tachycardia in the study group were slightly higher than those in the control group,but the differences were not statistically significant(P>0.05).Conclusion Noninvasive positive pressure ventilation combined with low dose milrinone has a significant effect in patients with severe cor-pulmonale heart failure with typeⅡrespiratory failure,which can effectively improve the heart function and pulmonary ventilation function of patients.