早期有创机械通气对于老年急性左心衰合并呼吸困难患者的疗效分析  

EFFECT OF EARLY INVASIVE MECHANICAL VENTILATION ON SENILE PAYIENYS WITH ACUTE LEFT HEART FAILURE COMPLICATED WITH DUSPNEA

作　　者：张丽[1] 吕婕[1] 王芳 杨芳杰 汤琳 高媛媛 于双梅 张于[1] 王宝民[1] ZHANG Li;LV Jie;WANG Fang;YANG Fangjie;TANG Lin;GAO Yuanyuan;YU Shuangmei;ZHANG Yu;WANG Baomin(Tangshan People’s Hospital,TangShan 063000,China)

机构地区：[1]河北省唐山市人民医院,063000

出　　处：《中国煤炭工业医学杂志》2022年第2期153-157,共5页Chinese Journal of Coal Industry Medicine

基　　金：2019年度河北省医学科学研究课题计划(编号:20191603)。

摘　　要：目的回顾性分析早期有创机械通气对老年左心功能衰竭合并呼吸困难患者的治疗效果。方法选取2018年6月—2020年12月唐山市人民医院重症医学科收治的急性左心衰合并呼吸困难的90例老年患者,按照治疗方法不同分为观察组(48例患者)和对照组(42例患者),对照组基础治疗加用无创通气辅以高流量氧疗,观察组基础治疗加用气管插管机械通气治疗,观察二组患者经不同治疗前后患者呼吸指标动脉血氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、心率(HR)、呼吸频率(RR)的变化;观察二组患者心功能指标B型钠尿肽(BNP)、肌酸激酶同工酶(CKMB)的变化;比较二组患者治疗效果,症状缓解时间及重症监护室住院时间的情况。结果经过基础治疗及两种改善通气的治疗后,观察组患者指标PaO_(2)、PaCO_(2)、HR、RR较对照组患者明显改善,差异有统计学意义(P<0.05)。观察组患者心功能指标BNP、CKMB较对照组患者明显降低,差异有统计学意义(P<0.05)。观察组患者的症状缓解时间及住重症监护室时间明显低于对照组,差异均有统计学意义(P<0.05)。结论对于老年急性左心衰合并呼吸困难患者早期行机械通气治疗能明显改善呼吸和心功能指标,从而缓解老年患者的临床症状,改善预后。Objective To analyze the effect of early invasive mechanical ventilation on elderly patients with left heart failure complicated with dyspnea.Methods A total of ninety elderly patients with acute left heart failure complicated with dyspnea admitted to the Department of Critical Care Medicine of Tangshan People′s Hospital from June 2018 to December 2020 were selected and depending on the treatment method divided into observation group(forty-eight patients)and control group(forty-two patients).Control group contain foundation treatment and noninvasive ventilation combined with high flow oxygen therapy;observation group contain based therapy combined with mechanical ventilation treatment after endotracheal intubation,then we observe two groups of patients before and after the patients were treated with different methods to improve breathing breathing index arterial blood oxygen partial pressure(PaO_(2)),CO_(2) partial pressure(PaCO_(2)),heart rate(HR),the change of respiratory frequency(RR);The changes of b-type natriuretic peptide(BNP)and creatine kinase isoenzyme(CKMB)of cardiac function indexes;The treatment effect,symptom relief time and length of stay in intensive care unit were compared between the two groups.Results After basic treatment and two treatments to improve ventilation,respiratory function indexes PaO_(2),PaCO_(2),HR and RR in observation group were significantly improved compared with control group,with statistical significance(P<0.05).The cardiac function indexes BNP and CKMB in observation group were significantly lower than those in control group,with statistical significance(P<0.05).Symptom relief time and stay in intensive care unit time in observation group were significantly lower than control group,the differences were statistically significant(P<0.05).Conclusion For elderly patients with acute left heart failure complicated with dyspnea,early mechanical ventilation can significantly improve Respiratory and cardiac function indicators,thus relieving theclinical symptoms and improving the

关 键 词：机械通气 左心功能衰竭 呼吸困难 

分 类 号：R541[医药卫生—心血管疾病]