无创呼吸机治疗急性左心衰伴呼吸困难的疗效观察  

Effect of Non-invasive Ventilator in the Treatment of Acute Left Heart Failure with Dyspnea

作　　者：郑刚[1] 朱凤亚 候朝钋 刘建[2] 李刘英[2] Zheng Gang;Zhu Fengya;Hou Chaopo;Liu Jian;Li Liuying(Department of Respiratory and Critical Care Medicine, Zigong First People’s Hospital, Zigong 643000, China;Department of Cardio-Encephalopathy of Integrated Traditional Chinese and Western Medicine, Zigong First People’s Hospital, Zigong 643000, China)

机构地区：[1]自贡市第一人民医院呼吸与危重症医学科,自贡643000 [2]自贡市第一人民医院中西医结合心脑病科,自贡643000

出　　处：《成都医学院学报》2022年第3期333-336,共4页Journal of Chengdu Medical College

基　　金：四川省中医药管理局重点学科建设项目(No:川中医函[2020]72号)。

摘　　要：目的探讨无创呼吸机治疗急性左心衰伴呼吸困难的临床效果及其对心钠肽(ANP)、脑钠肽(BNP)的作用。方法选择2019年3月至2020年3月在自贡市第一人民医院接受治疗的105例急性左心衰伴呼吸困难患者为研究对象,采用随机数字表法分为对照组(给予常规治疗,n=52)和试验组(给予无创呼吸机治疗,n=53)。比较两组临床疗效、心纳肽(ANP)、脑纳肽(BNP)、左室射血分数(LVEF)、左室舒张末内径(LVEDD)、短轴缩短率(FS)、pH值、动脉血氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))水平及并发症发生情况。结果治疗后,试验组总有效率高于对照组(P<0.05);两组血清ANP、BNP、LVEDD、PaCO_(2)降低,LVEF、FS、pH值、PaO_(2)水平升高,且试验组优于对照组,差异有统计学意义(P<0.05);试验组并发症总发生率低于对照组(P<0.05)。结论急性左心衰伴呼吸困难患者早期应用无创呼吸机可降低患者血清ANP、BNP水平,改善心功能,纠正血气指数。Objective To investigate the clinical effect of non-invasive ventilator in the treatment of acute left heart failure(ALHF)with dyspnea and its effect on atrial natriuretic peptide(ANP)and brain natriuretic peptide(BNP).Methods A total of 105 ALHF patients complicated with dyspnea treated in Zigong First People’s Hospital from March 2019 to March 2020 were selected and divided into two groups by random number table method.The control group(n=52)was given conventional treatment,while the experimental group(n=53)was given non-invasive ventilator treatment.Clinical efficacy,serum ANP,BNP,left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),fractional shortening(FS),pH value,partial pressure of oxygen(PaO_(2)),partial pressure of carbon dioxide(PaCO_(2)),and the total incidence of complications were compared between the two groups.Results After treatment,the total effective rate in the experimental group was significantly higher than in the control group(P<0.05).Serum ANP,BNP,LVEDD and PaCO_(2) decreased in both groups,while LVEF,FS,pH and PaO_(2) increased,and the above indexes in the experimental group were better than those in the control group,and the differences were statistically significant(P<0.05).The total incidence of complications in the experimental group was lower than that in the control group(P<0.05).Conclusion Early use of non-invasive ventilator in ALHF patients complicated with dyspnea can significantly reduce the levels of serum ANP and BNP,improve cardiac function and correct blood gas index.

关 键 词：无创呼吸机 急性左心衰 呼吸困难 心钠肽 脑钠肽 

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