双水平正压无创通气用于重度急性左心衰竭治疗中的临床效果分析  

Clinical Effect Analysis of Bi-level Positive Pressure Non-invasive Ventila⁃tion in the Treatment of Severe Acute Left Heart Failure

作　　者：杨庚 田丽红 YANG Geng;TIAN Lihong(The Second Affiliated Hospital of Xiamen Medical College,Xiamen,Fujian Province,361021 China)

机构地区：[1]厦门医学院附属第二医院,福建厦门361021

出　　处：《中外医疗》2023年第34期50-53,共4页China & Foreign Medical Treatment

摘　　要：目的 探讨双水平正压无创通气在重度急性左心衰竭患者中的应用效果。方法 随机选取2021年2月—2023年2月厦门医学院附属第二医院收治的60例重度急性左心衰竭患者为研究对象,按照随机数表法将其划分为参照组和研究组,每组30例。所有患者均将接受抗心力衰竭治疗。参照组应用机械通气方案,研究组采取双水平正压无创通气方案。比较两组干预前后的血气分析结果、血流动力学标、氧动力学指标水平。结果 干预后,研究组血二氧化碳分压(42.28±2.54)mmHg低于参照组,血氧分压(88.01±3.08)mmHg、血氧饱和度(95.51±3.64)%高于参照组,差异有统计学意义(t=27.440、38.599、6.433,P<0.001)。干预后,研究组中心动脉压、全身血管阻力低于参照组,心输出量高于参照组,差异有统计学意义(P<0.001)。干预12 h研究组氧供指标高于参照组,氧耗指标低于参照组,差异有统计学意义(P<0.05)。结论 双水平正压无创通气的应用,能够减轻重度急性左心衰竭患者的心肌损伤程度。同时,此种辅助治疗形式对改善患者的血流动力学指标作用突出,有助于加快其血气分析结果恢复,从而改善预后。Objective To explore the application effect of bi-level positive pressure non-invasive ventilation in pa-tients with severe acute left heart failure.Methods 60 patients with severe acute left heart failure admitted to the Sec-ond affiliated Hospital of Xiamen Medical College from February 2021 to February 2023 were randomly selected as the study objects and divided into reference group and study group of 30 patients each according to the random num-ber table method.All patients will receive anti-heart failure treatment.The reference group will apply mechanical ven-tilation program,and the study group will adopt bi-level positive pressure non-invasive ventilation program.The blood gas analysis results,hemodynamic markers,and oxygen kinetic index levels before and after the intervention were compared between the two groups.Results After intervention,blood carbon dioxide partial pressure(42.28±2.54)mmHg of the study group was lower than that of the reference group,and blood oxygen partial pressure(88.01±3.08)mmHg and oxygen saturation(95.51±3.64)%were higher than that of the reference group,and the differences were sta-tistically significant(t=27.440,38.599,6.433,P<0.001).After the intervention,the central arterial pressure and sys-temic vascular resistance of the study group were lower than that of the reference group,and the cardiac output was higher than that of the reference group,and the differences were statistically significant(P<0.001).After 12 h of inter-vention,the index of oxygen supply of the study group was higher than that of the reference group,and the index of oxygen consumption was lower than that of the reference group,and the differences were statistically significant(P<0.05).Conclusion The application of bi-level positive pressure non-invasive ventilation can reduce the degree of myo-cardial damage in patients with severe acute left heart failure.At the same time,this form of auxiliary treatment has a prominent role in improving the hemodynamic indexes of patients,which helps to accelerate the

关 键 词：重度急性左心衰竭 双水平正压无创通气机械通气 N-末端脑钠肽前体 血气分析指标 心肌损伤 

分 类 号：R5[医药卫生—内科学]