双水平气道正压无创通气辅助治疗重度子痫前期合并急性心力衰竭临床疗效

发布时间：2018-03-27 19:56

本文选题：正压呼吸　切入点：子痫　出处：《中国循环杂志》2015年12期

【摘要】：目的:探讨双水平气道正压(BiPAP)无创通气辅助治疗重度子痫前期合并急性心力衰竭(AHF)的临床疗效。方法:回顾性分析2008-01至2014-12我科收治的84例重度子痫前期合并AHF患者的临床资料,其中41例采用重度子痫前期及AHF的常规治疗(对照组),43例在对照组治疗基础上加用BiPAP通气辅助治疗(观察组),评估两组患者治疗前及治疗后3h发绀、呼吸困难、肺部Up音、心率、呼吸、动脉血氧饱和度(SaO_2)、动脉血氧分压(PaO_2)、动脉二氧化碳分压(PaCO_2)、pH值及B型利钠肽(BNP)等指标变化情况。结果:(1)观察组和对照组患者治疗后与治疗前比较:心率(次/min,对照组:90±8 vs 110±14、观察组:80±6 vs 112±12)、呼吸(次/min,对照组:24±5 vs 33±8,观察组:18±4 vs 35±7)、PaCO2(mmHg,对照组:41.3±4.3 vs 48.4±5.6、观察组:29.7±5.4 vs47.8±3.9)及BNP(ng/L,对照组:87.50±8.00 vs 133.00±8.00、观察组:69.50±8.30 vs 138.00±6.92)均下降,SaO_2(%,对照组:93.0±3.7 vs 80.5±4.7、观察组:97.1±3.4 vs 81.2±4.2)、PaO_2(mmHg,对照组:80.3±5.8 vs 80.5±4.7、观察组:89.1±6.2 vs 53.2±5.4,1 mmHg=0.133 kPa)均升高,差异均具有统计学意义(P均0.05)。(2)观察组与对照组治疗后比较:心率、呼吸、PaCO_2及BNP明显下降,SaO_2及PaO_2明显升高,差异均有统计学意义(P均0.05);治疗后两组pH值比较,差异无统计学意义(P0.05)。结论:BiPAP辅助治疗重度子痫前期并发AHF可改善患者的心衰症状和低氧血症。其临床意义尚须前瞻性临床研究加以证实。
[Abstract]:Objective: to investigate the clinical efficacy of BiPAP-based non-invasive ventilation in the treatment of severe preeclampsia complicated with acute heart failure. Methods: the clinical data of 84 patients with severe preeclampsia complicated with AHF from January 2008 to December 2014-12 were retrospectively analyzed. Among them, 41 cases were treated with routine treatment of severe preeclampsia and AHF (control group 43 cases were treated with BiPAP ventilation on the basis of control group) (observation group, the patients in both groups were evaluated for cyanosis, dyspnea, pulmonary up sound before treatment and 3 h after treatment. Heart rate, breathing, The changes of arterial oxygen saturation (SAO _ 2), Pao _ (2), PaCO _ (2) pH and B type natriuretic peptide (BNPs) were compared between the observation group and the control group after treatment. Weight 90 卤8 vs 110 卤14, observation group 80 卤6 vs 112 卤12, respiration: 24 卤5 vs 33 卤8, observation group: 18 卤4 vs 35 卤7 Paco _ 2mm Hg, control group: 41.3 卤4.3 vs 48.4 卤5.6, observation group: 29.7 卤5.4 vs47.8 卤3.9, control group 87.50 卤8.00 vs 133.00 卤8.00, observation group 69.50 卤8.30 vs 138.00 卤6.92), control group: 93.0 卤3.7 vs 80.5 卤4.7, observation group 93.4 卤3.4 vs 81.2 卤4.2mm HG, control group 87.50 卤8.30 vs 8.30 卤6.92mm, control group 93.0 卤3.7 vs 80.5 卤4.7, observation group 93.4 卤3.4 vs 81.2 卤4.2mm HgP, control group 87.50 卤8.30 卤8.30 卤6.92mm, control group 93.0 卤3.7 vs 80.5 卤4.7mm / h, control group: 87.50 卤8.00 vs 133.00 卤8.00, control group: 69.50 卤8.30 vs 138.00 卤6.92mm / g; control group: 93.0 卤3.7 vs 80.5 卤4.7mm / g; % 80.3 卤5.8 vs 80.5 卤4.7; the observation group: 89.1 卤6.2 vs 53.2 卤5.4 mmHg=0.133 KPA; Compared with the control group after treatment, the heart rate, Paco _ 2 and BNP in the observation group were significantly lower than those in the control group, and the levels of SaO2 and PaO_2 were significantly higher than those in the control group (P < 0.05), and the pH values of the two groups were compared after treatment. There was no significant difference (P 0.05). Conclusion the clinical significance of the adjunctive treatment of AHF in patients with severe preeclampsia can improve the symptoms of heart failure and hypoxemia, and its clinical significance should be confirmed by prospective clinical studies.
【作者单位】：内蒙古民族大学附属医院妇产科;
【分类号】：R714.2

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