早期无创正压通气对急性心力衰竭患者心排血量的影响  

Efficacy of Early Noninvasive Positive Pressure Ventilation on Cardiac Output in Patients with Acute Heart Failure

作　　者：冯阳 唐忠平[2] 聂丹阳 王迪芬[3] FENG Yang;TANG Zhongping;NIE Danyang;WANG Difen(Guizhou Medical University,Guiyang 550004,Guizhou,China;Intensive Care Unit,First People's Hospital of Guiyang,Guiyang 550002,Guizhou,China;Intensive Care Unit,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou,China)

机构地区：[1]贵州医科大学,贵州贵阳550004 [2]贵阳市第一人民医院重症医学科,贵州贵阳550002 [3]贵州医科大学附院重症医学科,贵州贵阳550004

出　　处：《贵州医科大学学报》2019年第3期331-334,共4页Journal of Guizhou Medical University

基　　金：国家临床重点专科建设项目(2011-170);贵州省高层次人才特助经费项目(TZJF-2011-25)

摘　　要：目的:探讨早期无创正压通气(NPPV)对急性心力衰竭患者心排血量(CO)的影响。方法:选择重症医学科住院的35例急性心力衰竭患者,在抗心衰治疗基础上,对照组18例予常规面罩吸氧,试验组17例予NPPV;比较两组患者的治疗效果,比较治疗前及治疗1 h时两组患者心率(HR)、呼吸频率(RR)、收缩压(SBP)、经皮血氧饱和度(SPO_2)、氧合指数(PaO_2/FiO_2)、B型利钠肽(BNP)及动脉血乳酸及CO水平,比较治疗前及治疗24 h时两组患者BNP及乳酸水平。结果:治疗前两组患者在性别、年龄、HR、RR、SBP、SPO_2、PaO_2/FiO_2、乳酸、CO、BNP等指标均无明显差异(P> 0. 05);治疗后试验组患者的HR、RR、SBP、SPO_2、PaO_2/FiO_2、乳酸、CO、BNP较对照组明显改善(P <0. 05);无创正压通气可有效提高AHF患者的CO,改善AHF患者的临床症状。结论:早期无创正压通气治疗可有效提高患者的CO,改善血流学指标。Objective:To investigate the effect of early non-invasive positive pressure ventilation(NPPV)on cardiac output(CO)in patients with acute heart failure.Methods:A total of 35 patients with acute heart failure were selected.On the basis of anti-heart failure treatment,18 cases in the control group were given routine mask oxygen inhalation and 17 cases in the experimental group were given NPPV.The therapeutic effects of the two groups were compared.The levels of heart rate(HR),respiratory rate(RR),systolic blood pressure(SBP),percutaneous oxygen saturation(SPO2),oxygenation index(PaO2/FiO2),B-type natriuretic peptide(BNP),arterial blood lactate and CO were compared before treatment and 1 hour after treatment.The levels of BNP and lactate in the two groups were compared before treatment and 24 hours after treatment.Results:There were no significant differences in gender,age,HR,RR,SBP,SPO2,PaO2/FiO2,lactate,CO,BNP between the two groups before treatment(P>0.05).Compared with the control group,HR,RR,SBP,SPO2,PaO2/FiO2,lactate,CO and BNP were significantly improved after treatment in the experimental group(P<0.05).Conclusion:EPPV can effectively improve CO and hemodynamic parameters of patients with acute heart failure.

关 键 词：心力衰竭 无创正压通气 无创心功能监测 心排血量 

分 类 号：R541.6[医药卫生—心血管疾病]