序贯性通气治疗重症急性左心衰竭合并呼吸衰竭的疗效  

Efficacy of sequential ventilation on severe acute left heart failure complicated with respiratory failure

作　　者：关庆楠 GUAN Qing-nan(Shenyang Tenth People's Hospital,Shenyang 110041,China)

机构地区：[1]沈阳市第十人民医院,110041

出　　处：《中国实用医药》2022年第13期28-30,共3页China Practical Medicine

摘　　要：目的 分析序贯性通气治疗重症急性左心衰竭合并呼吸衰竭的疗效。方法 78例重症急性左心衰竭合并呼吸衰竭患者,随机分为对照组和观察组,每组39例。对照组患者接受单纯有创机械通气治疗,观察组患者接受有创与无创序贯性通气治疗。比较两组机械通气时间、住院时间、治疗费用,治疗前后动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO_(2))水平,呼吸机相关性肺炎(VAP)发生情况。结果 观察组机械通气时间(10.21±1.24)d、住院时间(15.45±1.25)d均短于对照组的(16.57±2.26)、(26.52±2.95)d,治疗费用(2.34±0.54)万元少于对照组的(3.25±1.23)万元,差异具有统计学意义(P<0.05)。治疗前,两组患者PaCO_(2)、PaO_(2)水平比较,差异无统计学意义(P>0.05);治疗后,观察组PaCO_(2)(41.14±3.12)mm Hg(1 mm Hg=0.133 kPa)低于对照组的(44.56±4.89)mm Hg, PaO2(84.79±7.56)mm Hg高于对照组的(76.45±6.78)mm Hg,差异具有统计学意义(P<0.05)。观察组呼吸机相关性肺炎发生率为0,低于对照组的20.51%(8/39),差异具有统计学意义(P<0.05)。结论 有创与无创序贯性通气治疗重症急性左心衰竭合并呼吸衰竭的效果确切,可改善PaCO_(2)、PaO_(2)水平,缩短治疗时间和降低呼吸机相关性肺炎风险,减少费用。Objective To analyze the efficacy of sequential ventilation on severe acute left heart failure complicated with respiratory failure.Methods A total of 78 patients with severe acute left heart failure and respiratory failure were randomly divided into control group and observation group,with 39 cases in each group.Patients in the control group received invasive mechanical ventilation alone,and patients in the observation group received sequential invasive and non-invasive ventilation.Both groups were compared in terms of mechanical ventilation time,hospitalization time,treatment cost,arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))before and after treatment,and the occurrence of ventilator-associated pneumonia(VAP).Results The mechanical ventilation time(10.21±1.24)d and the hospitalization time(15.45±1.25)d in the observation group were shorter than(16.57±2.26)and(26.52±2.95)d in the control group,and the treatment cost(2.34±0.54)ten thousand yuan was less than(3.25±1.23)ten thousand yuan in the control group.All the differences were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in PaCO_(2) and PaO_(2) levels between the two groups(P>0.05).After treatment,the PaCO_(2)(41.14±3.12)mm Hg(1 mm Hg=0.133 kPa)in the observation group was lower than(44.56±4.89)mm Hg in the control group,and the PaO_(2)(84.79±7.56)mm Hg was higher than(76.45±6.78)mm Hg in the control group.All the differences were statistically significant(P<0.05).The incidence of ventilator-associated pneumonia in the observation group was 0,which was lower than 20.51%(8/39)in the control group,and the difference was statistically significant(P<0.05).Conclusion Sequential invasive and noninvasive ventilation is effective in the treatment of severe acute left heart failure complicated with respiratory failure,which can improve the levels of PaCO_(2) and PaO_(2),shorten the treatment time,reduce the risk of ventilator-associated pneumonia and

关 键 词：序贯性通气 重症急性左心衰竭 呼吸衰竭 呼吸机相关性肺炎 

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