脑钠肽联合心脏彩超评估无创通气支持对急性左心衰竭患者的治疗价值  

Application value of BNP combined with cardiac ultrasonic examination and noninvasive positive pressure ventilation in the treatment of acute left heat failure

作　　者：郭小芙[1] 吴允孚[1] 曹一飞[1] 陈刚 席与斌[1] 

机构地区：[1]苏州市立医院(东区)急诊科/GICU,江苏苏州215000

出　　处：《实用临床医药杂志》2013年第7期20-23,共4页Journal of Clinical Medicine in Practice

摘　　要：目的探讨应用无创呼吸机行正压通气治疗急性左心衰竭患者的临床疗效。方法采用随机数字表法将80例急性左心衰竭患者分为通气组和对照组。对照组给予利尿、强心及扩血管等药物治疗,通气组则在对照组的基础上应用无创呼吸机双水平正压通气治疗法。1周后对2组治疗效果进行评估。结果通气组的心率(HR)、呼吸率(RR)、平均动脉压(MAP)、动脉血氧分压(PaO2)及血氧饱和度(SaO2)等临床指标,血脑钠肽(BNP)变化及心脏超声指标与对照组相比,差异有统计学意义(P<0.05);通气组中治疗有效38例,有效率95.0%;而对照组中治疗有效31例,有效率77.5%,2组差异有统计学意义(P<0.05)。结论无创正压通气治疗急性左心衰竭患者疗效确切,能明显改善患者的心脏功能,值得临床推广应用。Objective To explore the clinical efficacy of noninvasive positive pressure venti- lation in the treatment of acute left heart failure （ALHF）. Methods Eighty ALHF patients were randomly divided into noninvasive positive pressure ventilation group and control group. The control group was administered the conventional treatment such as diuretics, cardiac inotropic agents, and the vasodilatation medicine. The ventilation group was administered bi-level noninvasive positive pressure ventilation in addition to the conventional treatment. The clinical efficacies of both groups were evaluated one week after the treatment. Results The differences of clinical indicators such as the heart rate （HR）, respiratory rate（RR）, mean arterial pressure （MAP）, arterial partial pressure of oxygen （PaO2） and oxygen saturation （SaO2）, brain natriuretic peptide （BNP） and cardiac ultra- sonic examination indicators in both groups had statistical significance （P 〈 0.05）. Thirty-eight pa- tients in the ventilation group were effectively cured, with an effectiveness rate of 95.0 %. While only 31 patients were effectively cured in the control group, with an effectiveness rate of 77.5 %. The differences of the two groups had statistical significance （P 〈 0.05）. Conclusion The applica- tion of noninvasive positive pressure ventilation can markedly improve the cardiac function of pa- tients. Thus, it is worthy of clinical application.

关 键 词：无创通气 急性心力衰竭 脑钠肽 心脏彩超 

分 类 号：R541[医药卫生—心血管疾病]