无创通气在急性左心衰合并低氧血症患者抢救中的临床价值  

Qinical Study of Non-invasive Ventilation in the Treatment of Acute Left Heart Failure with Hypoxemia

作　　者：严正[1] 许红阳[1] 胡纪根[1] 

机构地区：[1]江苏省无锡市第一人民医院急诊科,江苏无锡214002

出　　处：《中国临床医学》2006年第4期538-539,共2页Chinese Journal of Clinical Medicine

摘　　要：目的:评价无创机械通气在急性左心衰竭合并低氧血症抢救中的临床价值。方法:对28例急性左心衰合并低氧血症的患者在常规内科治疗同时加用无创性经面罩机械通气(NIV)治疗,观察无创通气(NIV)前后患者呼吸指标、肺气体交换与心率(HR)、平均动脉压(MAP)的变化。结果:28例患者均能耐受NIV治疗,无一例需要气管插管机械通气,临床症状明显改善,呼吸频率明显下降(P<0．05)。与NIV治疗前相比,患者的动脉血中pH、氧分压(PaO2)、二氧化碳分压(PaCO2)、氧饱和度(SaO2)等指标明显改善,HR与MAP明显减慢(P<0．05)。结论:经面罩NIV治疗急性左心衰时能迅速改善患者的症状和低氧血症,避免气管插管,是一种快速、安全、有效的方法。Objective：To asses the efficacy of non-invasive ventilation in the treatment of acute left heart failure with hypox emia. Methods：Twenty eight patients with acute left heart failure were treated with facial mask non -invasive ventilation （BiPAP） in addition to conventional treatment. The changes of clinical symptoms and arterial blood gas （pH, PaO2, PaCO2, SaO2 ） and heart rate together with mean arterial pressure were measured. Results： After non invasive ventilation, the clinical symptoms of all patients had been improved significantly. Also, the clinical parameters showed statistical differences （P〈 0. 05） compared with those before non-invasive ventilation. Therefore, endotracheal intubation could be avoided. Conclusion： Non-invasive ventilation could improve symptoms and hypoxemia in patients with acute left heart failure and endotracheal intubation was avoided in the patients studied. It is a safe and effective methods in treating acute left heart failure with hypoxemia.

关 键 词：心力衰竭 低氧血症 无创机械通气 

分 类 号：R541.6[医药卫生—心血管疾病]