强化心理应激干预联合序贯性通气应用于重症急性左心衰竭伴呼吸衰竭患者中的效果

Effectiveness of Intensive Psychological Stress Intervention Combined with Sequential Ventilation in Patients with Severe Acute Left Heart Failure with Respiratory Failure

目的:探讨强化心理应激干预联合序贯性通气应用于重症急性左心衰竭(ALHF)伴呼吸衰竭(RF)患者的效果。方法:选取2020年10月—2022年10月柳州市人民医院收治的重症急性ALHF伴RF患者76例为研究对象,根据奇偶数法分为对照组和观察组,各38例。对照组行常规治疗,观察组在对照组基础上行强化心理应激联合序贯性通气疗法。比较两组肺功能、心功能、心理状态。结果:治疗后,观察组每分钟最大通气量、呼气流速峰值、用力肺活量、第1秒用力呼气容积水平均高于对照组,差异有统计学意义(P<0.001);治疗后,观察组左室后壁舒张末期厚度、左心房内径、室间隔厚度、左心室舒张末期直径均低于对照组,差异有统计学意义(P<0.001);治疗后,观察组抑郁、焦虑、敌意、强迫评分低于对照组,差异有统计学意义(P<0.001)。结论:强化心理应激联合序贯性通气能改善心理状态,促使心功能、肺功能康复,且安全性较高。

Objective:To explore the effect of intensive psychological stress intervention combined with sequential ventilation ap⁃plied to patients with severe acute left heart failure(ALHF)with respiratory failure(RF).Methods:Seventy-six patients with se⁃vere acute ALHF with RF admitted to Liuzhou People's Hospital from October 2020 to October 2022 were selected as the study subjects,and were divided into the control group and the observation group according to the odd-even method,with thirty-eight patients in each group.The control group was treated conventionally,and the observation group was treated with intensive psycho⁃logical stress combined with sequential ventilation therapy on the basis of the control group.Pulmonary function,cardiac function and psychological state were compared between the two groups.Results:After treatment,the maximum ventilation per minute,peak expiratory flow rate,expiratory lung volume,and expiratory volume in the first second of exertion of the observation group were higher than that of the control group,and the difference was statistically significant(P<0.001);After treatment,the left ven⁃tricular posterior wall end-diastolic thickness,left atrial internal diameter,interventricular septal thickness,and left ventricular end-diastolic diameter of the observation group were lower than those of the control group,and the difference was statistically sig⁃nificant(P<0.001);After treatment,the scores of depression,anxiety,hostility,and compulsion in the observation group were low⁃er than those in the control group,and the difference was statistically significant(P<0.001).Conclusion:Intensive psychological stress combined with sequential ventilation can improve the psychological state,promote the recovery of cardiac function and pul⁃monary function,and is safe.