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无创正压机械通气治疗急性重度左心衰竭的临床价值

向常清,周敬群,曹志刚,张军,阮佼,潘劲芳,何玉霞   

  1. 三峡大学仁和医院
  • 收稿日期:2010-08-10 修回日期:2010-10-28 出版日期:2011-02-15 发布日期:2011-02-15
  • 通讯作者: 向常清

The clinical value of noninvasive positive pressure mechanical ventilation in acute left cardiac dysfunction

  • Received:2010-08-10 Revised:2010-10-28 Published:2011-02-15 Online:2011-02-15

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摘要： 摘要 目的：探讨双水平式呼吸道正压无创通气治疗急性重度左心力衰竭的可行性。方法：急性重度左心衰竭42例，在常规抗心力衰竭药物治疗的基础上。随机分成两组：BiPAP无创通气组、有创通气组，分别应用双水平式呼吸道正压无创呼吸机和有创呼吸机治疗，比较每组治疗前后、两组之间血压、心率、动脉血气变化和临床疗效。结果： BiPAP无创通气组和有创通气组治疗后心率、动脉血气均较治疗前好转，两组之间血压、心率、动脉血气变化和临床疗效在治疗前和治疗后差异无统计学意义(P>0．05)。结论：及早使用双水平式呼吸道正压通气结合抗心力衰竭药治疗急性重度左心衰竭，能及时有效地改善病人症状及低氧血症，对心功能改善有明显疗效。

关键词: 急性左心衰竭, 双水平式呼吸道正压, 机械通气

Abstract: Abstract Object To investigate the feasibility of bi-level positive airway pressure (BiPAP) mechanical ventilation applied in curing acute left cardiac dysfunction (ALCD). Methods Forty-two patients with ALCD were divided randomly into 2 groups: noninvasive positive pressure mechanical ventilation group in which the patients got the treatment of BiPAP mechanical ventilation, and invasive mechanical ventilation group. Both two groups all accepted the same routine drug therapy. Heart beats, arterial pressure, arterial blood gas analysis, and clinical symptoms before and after the treatment were compared between the two groups. Results Satisfied effects were obtained in both groups, and there was no significant difference between the two groups in heart beats, arterial pressure, arterial blood gas analysis, and clinical symptoms before and after treatment (P>0.05). Conclusions Patients with ALCD can obtain the benefit of early application of IPPV in improving clinical symptoms, redressing hypoxemia, and prompting heart function.

Key words: Acute left cardiac dysfunction, Bi-level positive airway pressure, Mechanical ventilation