无创呼吸机治疗对尿毒症并急性左心衰患者的临床疗效分析

发布时间：2017-12-30 19:35

本文关键词：无创呼吸机治疗对尿毒症并急性左心衰患者的临床疗效分析　出处：《第三军医大学学报》2016年21期 　论文类型：期刊论文

【摘要】：目的观察同时使用无创呼吸机辅助通气治疗对尿毒症并急性左心衰患者的疗效。方法对贵州省人民医院急诊内科门诊2013年11月至2016年3月63例确诊尿毒症并急性左心衰患者进行观察。将患者分为对照组[n=31,年龄(46.2±13.2)岁]及治疗组[n=32,年龄(47.2±14.8)岁]。对照组只进行常规吸氧、强心、利尿、扩血管治疗,治疗组在常规治疗同时进行无创呼吸机治疗。记录治疗前、治疗2 h末患者临床症状及心率(HR)、呼吸频率(RR)、收缩压(SBP)、舒张压(DBP)、动脉血氧分压(Pa O2)指标变化,2 h末血浆脑钠肽(BNP)、血乳酸(Lac)水平变化。结果治疗2 h末,与对照组比较,治疗组HR[(96.7±9.1)/min vs(106.6±10.3)/min]、RR[(21.0±1.6)/min vs(23.8±1.8)/min]、SBP[(140.1±9.2)mm Hg vs(148.5±19.0)mm Hg]、DBP[(86.2±6.4)mm Hg vs(98.8±10.2)mm Hg]、Pa O2[(96.6±5.7)mm Hg vs(87.2±7.7)mm Hg]、BNP[(1 721.0±794.6)ng/L vs(2 226.4±760.1)ng/L]、Lac[(3.50±1.27)mmol/L vs(4.74±1.42)mmol/L]均有改善(P0.05)。治疗组急诊透析率明显低于对照组(χ~2=14.385,P0.01)。治疗组治疗有效率高于对照组(χ~2=15.432,P0.01)。结论同时使用无创呼吸机辅助治疗能安全、有效地缓解尿毒症并急性左心衰患者临床症状及改善心功能。
[Abstract]:Objective to observe the effect of simultaneous use of non-invasive ventilator assisted ventilation on uremia patients with acute left heart failure. Methods 63 cases of outpatient department of emergency medicine department of Guizhou Provincial people's Hospital from November 2013 to March 2016 were treated. The patients with uremia complicated with acute left heart failure were observed. The patients were divided into control group. [Nong 31, age 46.2 卤13.2yr] and treatment group. [The control group was treated with routine oxygen inhalation, cardioversion, diuretic therapy and vasodilation. The treatment group was treated with non-invasive ventilator at the same time. At the end of 2 hours, the clinical symptoms, heart rate and HRN, respiratory frequency, systolic pressure and SBP, diastolic blood pressure and arterial partial pressure of oxygen (Pao _ 2) were changed. At the end of 2 h, the levels of BNPN and lactate Lacs in plasma were changed. Results at the end of 2 h after treatment, HR in the treatment group was higher than that in the control group. [Rpm 96.7 卤9.1 vs(106.6 卤10.3 min] RR. [21.0 卤1.6 vs(23.8 / min vs(23.8 卤1.8 / min. [Vs(148.5 (140.1 卤9.2 mm Hg 卤19.0 mm Hg). [Pao 2: 86.2 卤6.4 mm Hg vs(98.8 卤10.2 mm Hg. [BNPs 96.6 卤5.7 mm Hg vs(87.2 卤7.7 mm Hg. [1 721.0 卤794.6 ng / L vs(2 226.4 卤760.1 ng / L] Lac. [3. 50 卤1. 27 mmol / L vs(4.74 卤1. 42 mmol / L] all improved P 0. 05%. The emergency dialysis rate in the treatment group was significantly lower than that in the control group (P < 0. 05). 蠂 2 + 14.385. The effective rate in the treatment group was higher than that in the control group (蠂 ~ (2 +)). Conclusion it is safe to use non-invasive ventilator as adjuvant therapy at the same time. Effective relief of uremia patients with acute left heart failure clinical symptoms and improve cardiac function.
【作者单位】：贵州省人民医院急诊科;
【基金】：贵州省科技厅项目[黔科合J字[2010]2169号,黔科合LH字[2014]7026号]~~
【分类号】：R692.5;R541.6
【正文快照】： all P0.05).The proportion of emergent hemodialysis was significant lower(Chi square=14.385,P0.01),and clinical response was obviously higher(Chi square=15.432,P0.01)after 2 hours’treatmentin the treatment group than the control group.Conclusion Simul

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