双水平气道正压无创通气对重症心力衰竭患者血气指标和血流动力学及心功能的影响  

Effect of non-invasive bi-level positive airway pressure on blood gas indexes,hemodynamics and cardiac function in patients with severe heart failure

作　　者：唐晨 何盈盈[1] TANG Chen;HE Yingying(Department of Emergency Medicine,Guizhou Provincial People's Hospital,Guiyang,Guizhou,550002,China)

机构地区：[1]贵州省人民医院急诊内科,贵州贵阳550002

出　　处：《当代医学》2024年第3期48-51,共4页Contemporary Medicine

摘　　要：目的探讨双水平气道正压(BiPAP)无创通气对重症心力衰竭(HF)患者血气指标和血流动力学及心功能的影响。方法选取2018年5月至2021年6月于贵州省人民医院治疗的90例重症HF患者作为研究对象,依据治疗方式不同分为对照组与观察组,每组45例。对照组给予常规药物联合面罩吸氧治疗,观察组给予药物联合BiPAP无创通气治疗,比较两组治疗前后血气指标、血流动力学指标及心功能指标。结果治疗2h后,两组动脉血氧分压(PaO_(2))均高于治疗前,动脉血二氧化碳分压(PaCO_(2))均低于治疗前,且观察组PaO_(2)高于对照组,Pa-CO_(2)低于对照组,差异有统计学意义(P<0.05)。治疗2h后,两组右心房平均压(RAMP)、肺动脉平均压(PAMP)及肺动脉楔压(PCWP)均低于治疗前,而观察组RAMP、PAMP均高于对照组,PCWP低于对照组,差异有统计学意义(P<0.05)。治疗48h后,两组每搏输出量(SV)均大于治疗前,左心室射血分数(LVEF)高于治疗前,N末端B型脑钠肽前体(NT-proBNP)水平低于治疗前,且观察组SV、LVEF均高于对照组,NT-proBNP水平低于对照组,差异有统计学意义(P<0.05)。结论BiPAP无创通气治疗重症HF的效果理想,能有效改善患者血气、血流动力学指标及心功能,值得临床推广应用。Objective To investigate the effects of non-invasive bi-level positive airway pressure(BiPAP)ventilation on blood gas indexes,he-modynamics and cardiac function in patients with severe heart failure(HF).Methods A total of 90 patients with severe HF treated in Guizhou Pro-vincial People's Hospital from May 2018 to June 2021 were selected as research subjects,and they were divided into the control group and the obser-vation group according to different treatment methods,with 45 cases in each group.The control group was given conventional drugs combined with mask oxygen therapy,and the observation group was given drugs combined with BiPAP non-invasive ventilation therapy.Blood gas indexes,hemo-dynamic indexes and cardiac function indexes before and after treatment were compared between the two groups.Results 2 h after treatment,arteri-al partial pressure of oxygen(PaO_(2))of the two groups were higher than before treatment,and arterial carbon dioxide partial pressure(PaCO_(2))were lower than before treatment,and PaO_(2) in the observation group was higher than control group,PaCO_(2) was lower than the control group,the differenc-es were statistically significant(P<0.05).2 h after treatment,right atrial mean pressure(RAMP),mean pulmonary artery pressure(PAMP)and pul-monary artery wedge pressure(PCWP)of the two groups were lower than before treatment,while RAMP and PAMP in the observation group were higher than control group,and PCWP was lower than the control group,the differences were statistically significant(P<0.05).48 h after treatment,stroke volume(SV)of the two groups was larger than before treatment,left ventricular ejection fraction(LVEF)was higher than before treatment,N-terminal pro-brain natriuretic peptide(NT-proBNP)level was lower than before treatment,and SV in the observation group was larger than control group,LVEF was higher than control group,NT-proBNP level was lower than control group,the differences were statistically significant(P<0.05).Conclusion BiPAP is effective in treating severe HF,and can

关 键 词：重症心力衰竭 双水平气道正压无创通气 面罩吸氧 血气指标 血流动力学 心功能 

分 类 号：R541.6[医药卫生—心血管疾病]