早期无创通气在抢救急性左心衰竭合并呼吸衰竭患者中的临床应用  

Clinical application of early noninvasive ventilation in the rescue of acute left heart failure with respiratory failure

作　　者：王慧 WANG Hui(Licheng County People's Hospital,Changzhi 047600,China)

机构地区：[1]山西省长治市黎城县人民医院,047600

出　　处：《中国实用医药》2023年第15期37-40,共4页China Practical Medicine

摘　　要：目的探讨在抢救急性左心衰竭合并呼吸衰竭患者时早期无创通气的临床应用效果。方法94例急性左心衰竭合并呼吸衰竭患者,利用分组软件分为研究组与参照组,各47例。参照组在常规药物治疗基础上接受面罩吸氧,研究组接受常规药物治疗的同时采用早期无创通气治疗。比较两组预后转归情况、治疗前后的临床指标[呼吸频率(RR)、心率(HR)、血氧饱和度(SpO_(2))、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、C反应蛋白(CRP)、B型钠尿肽(BNP)]。结果研究组病情好转时间(4.29±1.87)h短于参照组的(7.61±2.08)h,好转率91.49%高于参照组的76.60%,气管插管率8.51%低于参照组的23.40%,差异有统计学意义(P<0.05)。治疗后,研究组RR、HR、PaCO_(2)、BNP、CRP分别为(18.88±8.21)次/min、(89.22±1.76)次/min、(43.54±2.31)mm Hg(1 mm Hg=0.133 kPa)、(232.24±77.31)pg/ml、(23.22±8.76)mg/L,低于参照组的(23.28±7.97)次/min、(90.88±1.34)次/min、(46.32±2.37)mm Hg、(346.53±73.64)pg/ml、(32.12±7.97)mg/L,SpO_(2)、PaO_(2)分别为(94.96±4.37)%、(94.99±5.38)mm Hg,高于参照组的(91.32±3.78)%、(85.16±5.87)mm Hg,差异有统计学意义(P<0.05)。结论急性左心衰竭合并呼吸衰竭患者采用早期无创通气抢救具有良好的效果,且能够改善患者缺氧状况,并减少插管率和死亡率。Objective To discuss the clinical effect of early noninvasive ventilation in the rescue of acute left heart failure with respiratory failure.Methods A total of 94 patients with acute left heart failure and respiratory failure were divided into research group and reference group by grouping software,with 47 cases in each group.The reference group received mask oxygen inhalation in addition to conventional drug therapy,while the research group received conventional drug therapy and early noninvasive ventilation.Both groups were compared in terms of prognostic outcome,and clinical indicators[respiratory rate(RR),heart rate(HR),blood oxygen saturation(SpO_(2)),arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),C-reactive protein(CRP),B-type natriuretic peptide(BNP)]before and after treatment.Results The time to improvement of disease of(4.29±1.87)h in the research group was shorter than that of(7.61±2.08)h in the reference group;the improvement rate of 91.49%in the research group was higher than that of 76.60%in the reference group;the tracheal intubation rate of 8.51%in the research group was lower than that of 23.40%in the reference group;the differences were statistically significant(P<0.05).After treatment,RR,HR,PaCO_(2),BNP and CRP were(18.88±8.21)times/min,(89.22±1.76)beats/min,(43.54±2.31)mm Hg(1 mm Hg=0.133 kPa),(232.24±77.31)pg/ml and(23.22±8.76)mg/L in the research group,which were lower than those of(23.28±7.97)times/min,(90.88±1.34)beats/min,(46.32±2.37)mm Hg,(346.53±73.64)pg/ml and(32.12±7.97)mg/L in the reference group;SpO_(2) and PaO_(2) were(94.96±4.37)%and(94.99±5.38)mm Hg in the research group,which were higher than those of(91.32±3.78)%and(85.16±5.87)mm Hg in the reference group;the differences were statistically significant(P<0.05).Conclusion Early noninvasive ventilation is effective in patients with acute left heart failure and respiratory failure,and can improve the hypoxia status of patients and reduce the rate of intubation and m

关 键 词：急性左心衰竭 呼吸衰竭 早期无创通气 效果 

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