无创呼吸机在ICU急性心力衰竭合并呼吸衰竭治疗中的应用  

Application of non-invasive ventilator in the treatment of acute heart failure merged with respiratory failure in ICU

作　　者：张秀敏[1] 武海燕[1] 孙晓娟[1] ZHANG Xiu-min WU Hai-yan SUN Xiao-juan(ICU, the Second Hospital Affiliated to Hebei North University, Zhangj iakou City 075100, Hebei Province, China)

机构地区：[1]河北北方学院附属第二医院ICU,河北张家口075100

出　　处：《海南医学院学报》2017年第4期528-530,共3页Journal of Hainan Medical University

基　　金：河北省科学技术研究与发展计划项目(1021112D)~~

摘　　要：目的:观察无创呼吸机在ICU急性心衰合并呼吸衰竭患者治疗中的应用效果。方法:选取我院2015年1月~2016年1月间ICU收治的急性心衰合并呼吸衰竭患者80例,随机分为观察组及对照组,各40例,两组入院均进行常规治疗,观察组给予无创呼吸机辅助呼吸,对照组患者给予持续低流量吸氧;对比两组治疗前后动脉血氧分压(PaO_2)、pH值、动脉血二氧化碳分压(PaCO_2)、血氧饱合度(SaO_2)及氧合指数(PaO_2/FiO_2)变化,并对比两组治疗前及治疗后24、48h血清氨基末端B型钠尿肽原(NT-pro BNP)及心肌肌钙蛋白I(cTnI)水平变化。结果:两组治疗前PaO_2(kPa)、pH值、PaCO_2(kPa)、SaO_2(%)及PaO_2/FiO_2比较无统计学差异(P>0.05),治疗后PaO_2、pH值、SaO_2及PaO_2/FiO_2较治疗前明显提高,PaCO_2较治疗前明显下降,治疗前后比较差异显著(P<0.05);观察组治疗后PaO_2、pH值、SaO_2及PaO_2/FiO_2明显高于同期对照组,PaCO_2明显低于同期对照组(P<0.05);两组治疗前NT-pro BNP、cTnI水平比较无统计学差异(P>0.05),治疗后12、24h时NT-pro BNP、cTnI水平比较较治疗明显上升(P<0.05);观察组治疗后12、24h时NT-pro BNP、cTnI水平比较均明显低于同期对照组(P<0.05)。结论:急性心衰合并呼吸衰竭患者给予无创呼吸机辅助通气,可显著改善患者血气指标,降低NT-pro BNP及cTnI水平,提高救治效果。Objective：To observe the application effect of non-invasive ventilator in the treatment of acute heart failure merged with respiratory failure in ICU.Methods：A total of 80 patients with acute heart failure merged with respiratory failure who were admitted in ICU from January,2015 to January,2016 were included in the study and randomized into the observation group and the control group with 40 cases in each group.The patients in the two groups were given routine treatments after ad-mission.On this basis,the patients in the observation group were given non-invasive ventilator.The patients in the control group were given continuous low flow oxygen inhalation.PaO2,pH,PaCO2,SaO2,and PaO2/FiO2 before and after treatment between the two groups were compared.The serum NT-pro BNP and cTnI levels before treatment,24 hand 48hafter treatment in the two groups were compared.Results：The comparison of PaO2,pH,PaCO2,SaO2,and PaO2/FiO2 before treatment between the two groups was not statistically significant（P〉0.05）.PaO2,pH,SaO2,and PaO2/FiO2 after treatment in the two groups were significantly elevated,while PaCO2 was significantly reduced when compared with before treatment（P〈0.05）.PaO2,pH,SaO2,and PaO2/FiO2 after treatment in the observation group were significantly higher than those in the control group（P〈0.05）,while PaCO2 was significantly lower than that in the control group（P〈0.05）.The comparison of NT-pro BNP and cTnI levels before treatment between the two groups was not statistically significant（P〈0.05）.NT-pro BNP and cTnI levels 12 hand 24hafter treatment in the two groups were significantly elevated when compared with before treatment（P〉0.05）.NT-pro BNP and cTnI levels 12 hand 24hafter treatment in the observation group were significantly lower than those in the control group（P〈0.05）.Conclusions：Non-invasive ventilator in the treatment of acute heart failure merged with respiratory failure can effectively improve the ventilation function,reduce NT-pro BNP and cTnI leve

关 键 词：无创呼吸机 急性心衰 呼吸衰竭 血气指标 氨基末端B型钠尿肽原(NT-pro BNP) 心肌肌钙蛋白I(cTnI) 

分 类 号：R541.61[医药卫生—心血管疾病] R563.8[医药卫生—内科学]