氧气驱动雾化吸入联合无创呼吸机治疗老年急性心力衰竭患者的效果分析  

Clinical curative effects of oxygen atomizing inhalation combined with noninvasive ventilation in elderly patients with acute heart failure

作　　者：焦薇[1] 胡世俊[1] 廖兴志[2] 

机构地区：[1]解放军第101医院护理部,江苏无锡214044 [2]解放军第101医院麻醉科,江苏无锡214044

出　　处：《海南医学院学报》2015年第2期200-202,205,共4页Journal of Hainan Medical University

基　　金：南京军区医学科技创新课题(MS073)~~

摘　　要：目的:探讨氧气驱动雾化吸入联合无创呼吸机治疗老年急性心力衰竭(AHF)患者的临床疗效及相关护理。方法:选取94例老年AHF患者随机分为3组:Ⅰ组31例,采用常规高流量面罩吸氧及雾化吸入;Ⅱ组31例,给以无创正压通气+常规雾化吸入;Ⅲ组32例,采用氧气驱动雾化吸入+正压通气,3组同时都给予常规药物治疗。比较3组治疗后的血气分析指标:血氧饱和度(SaO2)、氧分压(PO2)、二氧化碳分压(PCO2)、pH指标及呼吸频率(RR);心功能指标:心率(HR)、肺动脉楔压(PCWP)及每搏输出量(SV)、左室射血分数(EF)、心房脑钠离肽(BNP)的变化情况。结果:(1)Ⅰ、Ⅱ、Ⅲ组治疗后与治疗前比较,SaO2、PO2、PCO2明显升高,RR明显降低,差异具有统计学意义(P<0.05)。(2)治疗后24h,Ⅲ组SaO2、PO2明显高于Ⅰ、Ⅱ组,RR明显高于Ⅰ、Ⅱ组,差异均有统计学意义(P<0.05);(3)Ⅰ、Ⅱ、Ⅲ组治疗后与治疗前比较,HR、PCWP、BNP治疗后明显降低,SV、EF值明显升高,差异有统计学意义(P<0.05);(4)治疗后3d,Ⅲ组HR、PCWP、BNP明显低于Ⅰ、Ⅱ组,SV、EF明显高于Ⅰ、Ⅱ组,差异均有统计学意义(P<0.05)。结论:氧气驱动雾化吸入联合无创呼吸机治疗老年AHF临床效果良好,能够迅速纠正组织缺氧,改善心功能指标,降低心脏负荷,具有很大的临床价值。Objective： To study the clinical curative effect of oxygen atomizing inhalation combined with noninvasive ventilation in elderly patients with acute heart failure and related nursing. Methods： A total of 94 elderly patients with acute heart failure who received treatment in emergency center were randomly divided into three groups： group Ⅰ （31 cases） were treated with conventional high-flow oxygen and aerosol inhalation; group Ⅱ （31 cases） received the noninvasive positive pres- sure ventilation and conventional aerosol inhalation; group Ⅲ （32 cases） was treated with oxygen atomization inhalation and positive pressure ventilation, meanwhile the three groups were given conventional drug therapy. Blood gas analysis （SaO2, PO2, PCO2, and PH）, respiratory frequency （RR）, cardiac function index （HR, PCWP, SV, EF, and BNP） were observed and compared after treatment. Results： SaO2, PO2, PCO2 increased obviously after treatment, RR significantly decreased after treatment （P〈0.05）. （2） After 24 h treatment, SaO2, PO2 in group Ⅲ were significantly higher than group Ⅰ , Ⅱ , thedifference was statistically significant （P〈 0.05）, RR in group Ⅲ was significantly higher than that of group Ⅰ , Ⅱ , the difference was statistically significant （P〈0.05）. （3） After treatment, HR, PCWP, BNP significantly decreased after treat- ment; SV and EF increased significantly （P〈 0.05）. （4） After 3d of treatment, HR, PCWP, BNP in groupⅢ was lower than that of group Ⅰ , Ⅱ , the difference was statistically significant （P〈 0.05）, SV, EF in group Ⅲ were significantly higher than that of group Ⅰ , Ⅱ （P〈 0.05）. Conclusions： Curative effect of oxygen atomizing inhalation combined with noninvasive ventilation is effective on elderly patients with AHF, it can obviously improve cardiac function, correct the state of tissue hypoxia and reduce the cardiac load, the method are of great clinical value.

关 键 词：氧气驱动 雾化吸入 无创机械通气 老年 急性心力衰竭 

分 类 号：R541.6[医药卫生—心血管疾病]