无创呼吸机辅助通气联合吗啡治疗急性心肌梗死后心力衰竭的疗效分析

Efficacy analysis of non-invasive ventilator assisted ventilation combined with morphine in the treatment of heart failure after acute myocardial infarction

目的 讨论无创呼吸机辅助通气联合吗啡治疗急性心肌梗死后心力衰竭的临床疗效。方法 60例急性心肌梗死后心力衰竭患者,随机分为对照组和观察组,各30例。对照组患者采用无创呼吸机辅助通气治疗,观察组在对照组基础上联合吗啡进行治疗。比较两组治疗前后的临床指标[舒张压(DBP)、收缩压(SBP)、心率(HR)、呼吸频率(RR)、动脉血二氧化碳分压(PaCO_(2))、动脉氧分压(PaO_(2))、氧合指数(PaO_(2)/FiO_(2))]、急性生理与慢性健康评分(APACHEⅡ)评分、疗效。结果 治疗后,观察组PaO_(2)(95.7±3.1)mm Hg(1 mm Hg=0.133 kPa)、PaO_(2)/FiO_(2)(187.5±10.0)高于对照组的(80.2±3.0)mm Hg、(154.3±7.9), DBP(75.4±16.2)mm Hg、SBP(122.3±16.7)mm Hg、HR(74.1±5.0)次/min、RR(15.1±3.3)次/min、PaCO_(2)(35.7±2.9)mm Hg低于对照组的(89.1±22.0)mm Hg、(135.2±20.6)mm Hg、(93.5±6.0)次/min、(17.8±3.2)次/min、(46.7±3.3)mm Hg,差异均有统计学意义(P<0.05)。治疗后,观察组APACHEⅡ评分(9.7±4.2)分低于对照组的(12.8±3.9)分,差异有统计学意义(P<0.05)。观察组治疗总有效率为93.3%,高于对照组的73.3%,差异有统计学意义(P<0.05)。结论 无创呼吸机辅助通气联合吗啡在临床上治疗急性心肌梗死后心力衰竭患者能够获得良好的临床疗效,患者各项指标改善明显,临床推广价值较高。

Objective To discuss the clinical efficacy of non-invasive ventilator assisted ventilation combined with morphine in the treatment of heart failure after acute myocardial infarction. Methods A total of 60 patients with heart failure after acute myocardial infarction were randomly divided into control group and observation group, with 30 cases in each group. Patients in the control group were treated with non-invasive ventilator-assisted ventilation, and patients in the observation group were treated with morphine on the basis of the control group. Both groups were compared in terms of clinical indicators [diastolic blood pressure(DBP), systolic blood pressure(SBP), heart rate(HR), respiratory rate(RR), arterial partial pressure of carbon dioxide(PaCO),arterial partial pressure of oxygen(PaO), oxygenation index(PaO/FiO)], acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) score, and clinical efficacy. Results After treatment, the PaO(95.7±3.1) mm Hg(1 mm Hg=0.133 kPa) and PaO/FiO(187.5±10.0) in the observation group were higher than(80.2±3.0) mm Hg and(154.3±7.9) in the control group;in the observation group, the DBP was(75.4±16.2) mm Hg, the SBP was(122.3±16.7) mm Hg, the HR was(74.1±5.0) times/min, the RR was(15.1±3.3) times/min, the PaCOwas(35.7±2.9) mm Hg, which were lower than(89.1±22.0) mm Hg,(135.2±20.6) mm Hg,(93.5±6.0) times/min,(17.8±3.2) times/min,(46.7±3.3) mm Hg in the control group;the differences were all statistically significant(P<0.05). After treatment, the APACHE Ⅱ score(9.7±4.2) points of the observation group was lower than(12.8±3.9) points of the control group, and the difference was statistically significant(P<0.05). The total effective rate of the observation group was 93.3%, which was higher than 73.3% of the control group, and the difference was statistically significant(P<0.05). Conclusion Noninvasive ventilator assisted ventilation combined with morphine has a good clinical efficacy in patients with heart failure after acute myocardial infarction. The indicators of patients are significantly improved, and the clinical promotion value is high.