心功能综合指数评价无创正压通气对急性左心衰竭患儿心功能影响的研究  

Influence of noninvasive positive ventilation on heart function evaluated by Tel index in patients of acute left ventricular failure

作　　者：张逢博[1] 

机构地区：[1]河南省鹤壁煤业集团总医院儿科,458000

出　　处：《中国医药》2009年第10期812-814,共3页China Medicine

摘　　要：目的应用多普勒心功能综合指数（Tei指数）评价无创正压通气对急性左心衰竭患儿心脏整体功能的影响。方法32例急性左心衰竭患儿，在常规治疗不能有效控制的基础上加用双水平正压通气（bi-level positive airway pressure，BiPAP）呼吸机治疗，观察治疗前和治疗后2h血气分析、血压、心率及呼吸频率等指标的变化，并在机械通气前后均采用超声心动图测定左心室射血分数、左心房室瓣舒张早期与舒张晚期血流峰值速度比值及Tei指数。结果经口鼻面罩BiPAP呼吸机治疗后，29例患儿血气分析、血压、心率及呼吸明显改善，治疗有效率为90．6％。BiPAP治疗前后Tei指数差异有统计学意义（分别为0．72±0．05．0．60±0．02，P〈0．05）。结论BiPAP可明显改善急性左心衰竭患儿的心功能，改善低氧血症；Tei指数是一种无创、敏感、准确、综合评价心脏整体功能的重要指标。Objective To study of the influence of bi - level positive airway pressure（BiPAP） mechanucal ventilation on heart function evaluated by Tel index in patients of acute ventricular failure. Methods Thirty-two patients of acute left ventricular failure received BiPAP mechanical ventilation treatment when the conservative treat- ment was not effective. The blood gas nanlysis （ Ph, PaO2,O2, SaO2 ） , blood pressure, heart rate and breathing rate were observed before and after 2 -hour treatment. Meanwhile left ventrieular ejection fraction （LVEF） ,E/A and Tel index were measured by eehoeardiography. Results The blood gas analysis, blood pressure, heart rate and breath- ing rate of 29 patients significantly improved after BiPAP mechanical ventilation, the effective rate was 90.6%. The Tel index after the treatment was significantly lower than that before the treatment（0.72±0. 05,0.60 ± 0.02, P 〈 0.05 ）. There was a significantly negative correlation between Tel index and LVEF （ r = - 0.56, P 〈 0.05 ） , but no significantcorrelation between Tel index and E/A （ r = 0.32,P 〉 0.05 ）. Conclusion The use of BiPAP mechanical ventilation can improve cardiac function and hypoxemia in the patients of acute left ventrieular failure. Tel index is a noninvasive, sensitive, accurate and new index that can evaluate the heart function.

关 键 词：急性左心衰竭 TEI指数 无创正压通气 

分 类 号：R541.4[医药卫生—心血管疾病]