心肺超声联合心电图监测对无创通气治疗心源性肺水肿的疗效分析

Efficacy Analysis of Cardiopulmonary Ultrasound Combined with Electrocardiogram Monitoring on Non-invasive Ventilation in the Treatment of Cardiogenic Pulmonary Edema

目的探究心肺超声联合心电图监测对无创通气治疗心源性肺水肿的疗效。方法以该院50例心源性肺水肿患者为对象,研究时间是2019年3月-2020年3月,均采用无创通气治疗,其中25例治疗成功,视为研究组,25例治疗失败,视为参照组,比两组患者的心肺超声参数,分析无创正压通气治疗失败影响因素。心电图监测结果作为辅助分析。结果研究组患者右心室侧壁Sm(11.94±2.45)cm/s、二尖瓣E/e(13.96±1.56)、二尖瓣返流速率(2.05±0.41)m/s、肺动脉收缩压(28.95±5.64)mmHg与参照组比较,差异有统计学意义(t=4.693、7.322、5.161、6.351,P<0.05)。研究组患者PaO_(2)/FiO_(2)(212.56±54.46)mmHg、房颤发生率(4.00%)与参照组比较,差异有统计学意义(t=3.387,χ^(2)=4.878,P<0.05)。心电图监测结果均正常。使用Logistic回归分析,心源性肺水肿患者使用无创正压通气治疗失败影响因素包括右心室Sm、二尖瓣E/e、肺动脉收缩压(P<0.05)。结论心源性肺水肿使用无创通气治疗时,可使用肺部超声诊断,并联合心电图监测,通过获取二尖瓣E/e、肺动脉收缩压、肺部超声评分,以及心电图辅助监测,可评估治疗效果。

Objective To explore the effect of cardiopulmonary echocardiography combined with ECG monitoring on non-invasive ventilation in the treatment of cardiogenic pulmonary edema.Methods Fifty patients with cardiogenic pulmonary edema in the hospital were taken as the object.The study period was from March 2019 to March 2020.All of them were treated with non-invasive ventilation.Among them,25 cases were successfully treated and regarded as the study group,and 25 cases failed as the reference group,compared with the heart and lung ultrasound parameters of the two groups of patients,the factors affecting the failure of non-invasive positive pressure ventilation were analyzed.The ECG monitoring results were used as auxiliary analysis.Results The right ventricular side wall Sm(11.94±2.45)cm/s,mitral valve E/e(13.96±1.56),mitral valve regurgitation rate(2.05±0.41)m/s,pulmonary artery systolic pressure(28.95±5.64)mmHg and compared with the reference group,the difference was statistically significant(t=4.693,7.322,5.161,6.351,P<0.05).PaO_(2)/FiO_(2) in the study group was(212.56±54.46)mmHg and the incidence of atrial fibrillation was(4.00%),which was statistically significant compared with the reference group(t=3.387,χ^(2)=4.878,P<0.05).The results of ECG monitoring were normal.Using Logistic regression analysis,influencing factors for the failure of noninvasive positive pressure ventilation in patients with cardiogenic pulmonary edema included right ventricle Sm,mitral valve E/e,pulmonary artery systolic pressure,and constant(P<0.05).Conclusion When noninvasive ventilation is used for the treatment of cardiogenic pulmonary edema,lung ultrasound diagnosis can be combined with ECG monitoring.The treatment can be evaluated by obtaining mitral valve E/e,pulmonary artery systolic pressure,lung ultrasound score,and ECG auxiliary monitoring Effect.