BiPAP正压通气在治疗老年急性心肌梗死合并肺水肿患者中的应用研究  

Application Research on Bi PAP Positive Pressure Ventilation in the Treatment of Elderly Patients With Acute Myocardial Infarction and Pulmonary Edema

作　　者：赵艳辉[1] 冯国鹏 高瑾[1] 冯玲[1] 甄秀丽[1] 

机构地区：[1]天津市武清区人民医院心内一科,天津301700

出　　处：《继续医学教育》2016年第5期99-101,共3页Continuing Medical Education

基　　金：天津市武清区科技发展计划项目(WQKJ201432)

摘　　要：目的探讨Bi PAP无创正压通气在治疗急性心肌梗死合并左心衰竭的患者,可以快速缓解症状,达到再血管化治疗的条件。方法将60例急性心肌梗死并左心衰竭患者随机数字表法分为观察组和对照组,2组患者均接受常规治疗,观察组患者在常规治疗的基础上应用无创正压通气起始压力IPAP 8~15 cm H2O,EPAP 4~12 cm H2O,在患者能够耐受的情况下每5 min增加2 cm H2O的压力。比较两组患者治疗后相关指标及两组患者能够符合再血管化治疗条件时间。结果与对照组比较,观察组患者二氧化碳分压（Pa CO2）、呼吸频率（RR）、心率（HR）、收缩压（SBP）及体位改善更显著,氧分压（Pa O2）及氧饱和度（Sa O2）升高更显著（t=4.358、5.043、7.138、4.371、6.381、6.371,均P〈0.05）;观察组患者达到能够进行再血管化治疗条件的时间明显缩短。（χ2=70.555 6、14.444 4,t=6.683 8,均P〈0.01）。结论在急性心肌梗死合并左心衰竭的治疗中,无创正压通气能够快速改善患者心脏功能、肺通气及换气功能,缩短达到再血管化治疗条件的时间,为进行血管再通治疗创造条件。Objective Bi PAP noninvasive positive pressure ventilation therapy in patients with acute myocardial infarction and left heart failure, can quickly relieve symptoms, treatment of conditions for achieve revascularization Methods 60 cases with AMI and CHF were randomly divided into 2 groups. Patients in the observation group were treated with noninvasive positive pressure ventilation pressure. Then compare two groups of patients after treatment related indicators and treatment conditions for two groups of patients are able to meet revascularization. Results Compared with control group, observation group of patients with Pa CO2, RR and HR, SBP and position to improve more prominent, Pa02 and Sa O2 increased more significantly. Observation group of patients to treatment time significantly shortened the conditions for revascularization. Conclusion In the treatment of AMI and CHF, noninvasive positive pressure ventilation can improve the patients＇ heart function quickly, pulmonary ventilation and ventilation function, to shorten the time of treatment conditions for achieve revascularization, to create conditions for recanalization therapy.

关 键 词：心肌梗死 左心衰竭 再血管化 连续气道正压通气 

分 类 号：R541[医药卫生—心血管疾病]