两种无创通气模式治疗急性左心衰的临床疗效研究  

Clinical research on the treatment of acute left heart failure with two different noninvasive ventilation procedures

作　　者：何菲[1] 高崇瀚[2] 邹凡文[1] 张遥衡[1] He Fei, Gao Chong - han, Zou Fan - wen, Zhang Yao - heng.(Department of Geriatrics, Affiliated Yongchuan Hospital, Chongqing Medical University, Chongqing 402160, Chin)

机构地区：[1]重庆医科大学附属永川医院老年科,重庆402160 [2]重庆医科大学附属永川医院心内科,重庆402160

出　　处：《中国急救医学》2018年第3期237-239,共3页Chinese Journal of Critical Care Medicine

基　　金：重庆永川区科委自然科学基金项目（YCSTC,2012DB5001）

摘　　要：目的 比较无创压力支持通气（PSV）和成比例辅助通气（PAV）对急性左心衰患者肺水肿的疗效。方法 选择我院收治的急性左心衰患者111例，随机分成三组，对照组予以常规治疗，PAV组予以PAV＋常规治疗，PSV组予以PSV＋常规治疗，比较治疗前以及治疗后 1 h的血气分析、血压、心率、呼吸频率、氧合指数等指标，并记录患者对通气舒适度的评价。结果 治疗后PSV、PAV组的氧合指数、PaO2明显高于对照组（P＜0.05），治疗后PSV组、PAV组的RR、HR、MAP明显低于对照组（P＜0.05）；但治疗后PSV组与PAV组的RR、HR、MAP、氧合指数、PaO2比较差异无统计学意义（P＞0.05）。而PAV组舒适度评分明显低于PSV组（P＜0.05）。结论 与对照组比较，PAV、PSV模式对改善急性左心衰患者呼吸困难症状及氧合指数均有显著疗效。两种模式对急性左心衰患者的疗效比较差异无统计学意义，PAV舒适性较PSV好。Objective -To compare the efficacy of noninvasive pressure support ventilation （PSV） and proportional assist ventilation （PAV） in the treatment of pulmonary edema in patients with acute left heart failure. Methods A total of 111 patients with acute left heart failure were randomly divided into 3 groups. The control group received conventional drug therapy, PAV group was treated with proportional assisted ventilation and routine treatment therapy, PSV group received noninvasive pressure support ventilation and conventional drug treatment. Blood gas analysis, blood pressure 1 hour before and after treatment, heart rate, respiratory rate, oxygenation index, and ventilation comfort were compared between groups. Results After treatment, oxygenation index and PaO2 in the PSV group, PAV group was significantly higher than the control group, the difference was statistically significant （ P 〈 0.05 ）. After treatment, RR, HR, MAP in the PSV group and PAV group was significantly lower than the control group, the difference was statistically significant （P 〈 0. 05）. But after treatment, there was no significant difference in RR, HR, MAP, oxygenation index, PaO2 between PSV group and PAV group after treatment （P 〉 0.05 ）. PAV group comfort score was significantly lower than that of PSV group, the difference was statistically significant （P 〈 0.05）. Conclusion PAV and PSV have significant effects on improving the symptoms of dyspnea and oxygenation index in patients with acute left heart failure. There is no significant difference between the two procedures in the treatment of acute left heart failure, and PAV is better than PSV in comfort.

关 键 词：无创通气 急性左心衰 临床疗效 无创压力支持通气(PSV) 成比例辅助通气(PAV) 

分 类 号：R541.6[医药卫生—心血管疾病]