无创正压通气应用于重度急性左心衰合并II型呼吸衰竭患者的抢救

发布时间：2018-01-17 15:40

本文关键词：无创正压通气应用于重度急性左心衰合并II型呼吸衰竭患者的抢救　出处：《中国现代医学杂志》2015年25期 　论文类型：期刊论文

【摘要】：目的探讨无创正压通气治疗重度急性左心衰合并II型呼吸衰竭的效果。方法 2011年1月-2014年1月,该院80例重度急性左心衰合并II型呼吸衰竭患者,根据随机数字法,将其分为对照组(持续正压通气)和观察组(无创正压通气),每组各40例,观察和比较治疗前后两组收缩压(SBP)、舒张压(DBP)、心率(HR)、呼吸频率、脑钠肽(BNP)、K+、Na+,动脉氧分压(Pa O2)、二氧化碳氧分压(Pa CO2)、左室射血分数(LVEF)及每搏输出量(SV)变化情况。结果与对照组相比,观察组治疗后SBP、DBP、HR及呼吸频率均明显降低,P0.05;与对照组相比,观察组治疗后BNP、K+及Na+水平均显著降低,P0.05;与对照组相比,观察组治疗后Pa O2明显增高,Pa CO2显著降低,LVEF及SV均明显改善,P0.05。结论无创正压通气治疗能够明显改善重度急性左心衰合并II型呼吸衰竭患者的生命体征、血气指标及心功能,提高患者的预后质量。
[Abstract]:Objective to investigate the effect of noninvasive positive pressure ventilation on severe acute left heart failure with type II respiratory failure. Methods from January 2011 to January 2014. 80 patients with severe acute left heart failure complicated with type II respiratory failure were randomly divided into control group (continuous positive pressure ventilation) and observation group (40 cases in each group). Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HRN), respiratory rate, brain natriuretic peptide (BNPP) and arterial partial pressure of oxygen (PaO2) were observed and compared before and after treatment. The changes of Paco _ 2, LVEF (left ventricular ejection fraction) and SVV per stroke output were compared with those in the control group. HR and respiratory frequency decreased significantly (P 0.05). Compared with the control group, the levels of BNPK and Na in the observation group were significantly lower than those in the control group (P 0.05). Compared with the control group, Pao 2 was significantly increased in the observation group. Pa CO2 was significantly decreased in the observation group. Both LVEF and SV were significantly improved in the observation group. Conclusion Non-invasive positive pressure ventilation can significantly improve the vital signs, blood gas index and cardiac function of patients with severe acute left heart failure combined with type II respiratory failure, and improve the quality of prognosis of the patients.
【作者单位】：北京市第六医院急诊科;
【分类号】：R541.6;R563.8
【正文快照】： 重度急性左心衰作为急诊科比较常见的危重疾病,是以左心室结构和功能严重障碍为主要症状的综合征[1]。重度急性左心衰患者由于左心室充盈不足、左室射血减少,心排出量明显降低,不能满足机体正常代谢需求,患者多伴有较为严重的呼吸衰竭,甚至危及生命[2]。目前,无创正压通气治疗

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