重症急性左心衰竭患者治疗中有创机械通气的应用时机探讨  

The opportunity to use invasive mechanical ventilation in the treatment of patients with severe ALVF

作　　者：王丽辉[1] 申亚晖[1] 郭艳青[1] 臧宾宾[1] 董晓瑞[1] 孙治霞[1] WANG Li-hui SHEN Ya-hui GUO Yan-qing ZANG Bin-bin DONG Xiao-rui SUN Zhi-xia(Henan Province Hospital of Traditional Chinese Medicine, Zhengzhou 450000, Chin)

机构地区：[1]河南省中医院重症医学科,河南郑州450000

出　　处：《中国临床医生杂志》2016年第12期23-26,共4页Chinese Journal For Clinicians

摘　　要：目的探讨重症急性左心衰竭患者早期应用有创机械通气治疗的临床效果。方法对85例重症急性左心衰竭患者进行回顾性分析,采用随机数字表法将85例患者分为观察组和对照组。其中观察组47例,发病即采取气管插管有创机械通气治疗,对照组38例,发病后采用无创通气治疗,如治疗1小时患者症状未见改善,即采用有创机械通气治疗,对比两组治疗效果。结果观察组与对照组治疗即刻动脉血氧分压(PaO_2)、呼吸频率(RR)、心率(HR)、血氧饱和度(SaO_2)测定值差异无显著性(P>0.05);治疗后0.5、1、3小时两组患者的平均PaO_2、RR、HR、SaO_2测定值较本组治疗前均显著好转(P<0.05),其中观察组好转效果均优于对照组(P<0.05);治疗后第3小时观察组平均动脉压(MAP)、pH均显著高于对照组(P<0.05);治疗1小时后,观察组治疗总有效率91.49%,显著高于对照组(P<0.05)。结论早期应用有创通气抢救重症急性左心衰竭患者有利于及时改善患者缺氧及生命体征指标,提高治疗效果。Objective To investigate the clinical effect of invasive mechanical ventilation in the early stage of severe ALVF patients.Method 85 patients with severe ALVF therapy were retrospectively analyzed,in the early group,47 patients were treated with invasive mechanical ventilation after the onset of the disease,and 38 patients in the control group were treated with noninvasive ventilation,such as the treatment of 1h patients with symptoms did not improve the use of invasive mechanical ventilation treatment,compared with the two groups of treatment effect.Result There was no significant difference in the values of PaO2,RR,SaO2 and Oh between the early group and the control group at HR time（P〉0.05）,The average PaO2,RR,HR and SaO2 values of the groups after treatment were significandy better than before treatment（P〈0.05）.The values of 0.5h,lh,3h in the two groups were significandy better than before treatment,the early group better than the control group（P〈0.05）.In the early group,the MAP and pH were significandy higher than those in the control group（P〈0.05） in the treatment of 3h;After 1h treatment,the total effective rate of the early group was 91.49%higher than that of the control group（P〈0.05）.Conclusion Early application of invasive ventilation in patients with rescue ALVF conducive to the timely and vital signs improved patient blood gas index,improve the therapeutic effect.

关 键 词：重症急性左心衰竭 早期 有创 机械通气 

分 类 号：R541[医药卫生—心血管疾病]