无创呼吸机在急诊急性心力衰竭合并呼吸衰竭患者治疗中的应用体会  

Experience of noninvasive ventilator in emergency treatment of patients with acute heart failure and respiratory failure

作　　者：曹鸽 孟艳[1] 卢宁[1] CAO Ge;MENG Yan;LU Ning(Emergency Department,Huludao Central Hospital,Huludao 125000,China)

机构地区：[1]葫芦岛市中心医院急诊科,125000

出　　处：《中国现代药物应用》2021年第23期5-8,共4页Chinese Journal of Modern Drug Application

摘　　要：目的 探讨急诊急性心力衰竭(AHF)合并呼吸衰竭(RF)患者治疗中应用无创呼吸机的临床意义。方法 选取74例急诊AHF合并RF患者,经随机数字表法分为参照组和治疗组,每组37例。参照组行常规对症治疗,治疗组在参照组基础上加用无创呼吸机治疗。对比两组治疗前后血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、血氧饱和度(SpO_(2))],治疗前后心功能指标[左室射血分数(LVEF)、左室舒张末期内径(LVEDd)、左室收缩末期内径(LVESd)],治疗后临床疗效。结果 治疗后,两组PaO_(2)与SpO_(2)水平均较治疗前上升, PaCO_(2)水平均较治疗前下降,差异具有统计学意义(P<0.05);治疗后,治疗组PaO_(2)(8.59±1.28)kPa、SpO_(2)(92.64±8.41)%高于参照组的(7.96±1.34)kPa、(85.64±8.36)%, PaCO_(2)(5.23±1.28)kPa低于参照组的(6.13±1.32)kPa,差异具有统计学意义(P<0.05)。治疗后,两组LVEF均较治疗前明显上升, LVEDd、LVESd均较治疗前明显缩短,差异具有统计学意义(P<0.05);治疗后,治疗组LVEF(48.91±5.79)%高于参照组的(42.14±5.82)%, LVEDd(51.14±4.31)mm、LVESd(38.14±3.76)mm明显短于参照组的(54.68±4.29)、(41.36±3.86)mm,差异具有统计学意义(P<0.05)。治疗组治疗总有效率94.59%高于参照组的75.68%,差异具有统计学意义(P<0.05)。结论 急诊AHF合并RF患者治疗过程中应用无创呼吸机,对血氧及心功能情况改善明显,且总有效率明显提升。Objective To discuss the clinical significance of noninvasive ventilator in emergency treatment of patients with acute heart failure(AFH)and respiratory failure(RF).Methods A total of 74 patients with AHF and RF in the emergency department were divided into the reference group and the treatment group by the random numerical table,with 37 cases in each group.The reference group was treated with conventional symptomatic therapy,and the treatment group was treated with noninvasive ventilator on the basis of the reference group.Both groups were compared in terms of blood gas indexes[arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),blood oxygen saturation(SpO_(2))],cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDd),left ventricular end-systolic diameter(LVESd)]before and after treatment,and clinical efficacy after treatment.Results After treatment,the levels of PaO2 and SpO2 in the two groups increased compared with those before treatment in this group,and the level of PaCO2 decreased compared with those before treatment in this group,and the difference was statistically significant(P<0.05).After treatment,the PaO2(8.59±1.28)kPa and SpO_(2)(92.64±8.41)%of the treatment group were higher than(7.96±1.34)kPa and(85.64±8.36)%of the reference group,and the PaCO_(2)(5.23±1.28)kPa was lower than(6.13±1.32)kPa of the reference group,and the difference was statistically significant(P<0.05).After treatment,the LVEF in the two groups were significantly higher than those of this group before treatment,and the LVEDd and LVESd were significantly lower than those of this group before treatment.All the differences were statistically significant(P<0.05).After treatment,the LVEF(48.91±5.79)%in the treatment group was higher than(42.14±5.82)%in the reference group,and the LVEDd(51.14±4.31)mm and LVESd(38.14±3.76)mm were significantly smaller than(54.68±4.29)and(41.36±3.86)mm in the reference group,and the differenc

关 键 词：急诊 急性心力衰竭 呼吸衰竭 无创呼吸机 血气指标 

分 类 号：R541.6[医药卫生—心血管疾病] R563.8[医药卫生—内科学]