论文部分内容阅读
目的探讨双水平正压无创通气与常规有创机械通气在重度急性左心衰竭治疗中的作用。方法重度急性左心衰竭患者110例在常规治疗基础上,55例行双水平正压无创通气治疗者为观察组,另55例行常规有创机械通气治疗者为对照组。比较2组呼吸功能指标、血流动力学指标、氧动力学指标及心功能指标间差异。结果2组治疗前、后pa(O2)、pa(CO2)、血氧饱和度比较差异无统计学意义(P>0.05);治疗后观察组中心动脉压、心输出量、全身血管阻力分别为(121.17±8.47)mm Hg、(4.35±0.28)L/min、(1 937.36±212.54)dyn/cm,对照组分别为(138.27±7.96)mm Hg、(4.13±0.13)L/min、(2 317.43±209.47)dyn/cm,2组比较差异均有统计学意义(P<0.05);观察组治疗12h后氧供及氧耗水平分别为(434.38±32.17)、(192.17±20.68)mL/min,均高于对照组((389.26±39.47)、(180.22±18.60)mL/min)(P<0.05);治疗6、12、24h时观察组Tei指数((0.77±0.06)、(0.69±0.03)和(0.68±0.04))小于对照组((0.83±0.05)、(0.74±0.04)和(0.73±0.03)),差异均有统计学意义(P<0.05)。结论与有创机械通气比较,双水平正压无创通气辅助治疗重度急性左心衰竭,可在保证有效通气基础上降低患者心脏负荷,提高其心脏功能。
Objective To investigate the effect of bi-level positive pressure noninvasive ventilation and conventional invasive mechanical ventilation on the treatment of severe acute left heart failure. Methods A total of 110 patients with severe acute left heart failure were selected as the observation group on the basis of routine treatment. 55 patients underwent bi-level positive pressure noninvasive ventilation as the observation group and the other 55 patients underwent routine mechanical ventilation as the control group. The differences of respiratory function, hemodynamics, oxygenation and cardiac function between the two groups were compared. Results There was no significant difference in paO2, pa (CO2) and oxygen saturation between the two groups before and after treatment (P> 0.05). After treatment, the central arterial pressure, cardiac output and systemic vascular resistance were (121.17 ± 8.47) mm Hg, (4.35 ± 0.28) L / min, and (1937.36 ± 212.54) dyn / cm in the control group and (138.27 ± 7.96) mm Hg and (4.13 ± 0.13) 317.43 ± 209.47) dyn / cm, the difference between the two groups was statistically significant (P <0.05). The levels of oxygen supply and oxygen consumption in the observation group after treatment for 12h were (434.38 ± 32.17), (192.17 ± 20.68) mL / min (P <0.05). The Tei index (0.77 ± 0.06) and (0.69 ± 0.03) in the observation group at 6, 12 and 24 h were significantly higher than those in the control group (389.26 ± 39.47 and 180.22 ± 18.60 mL / min, respectively) ) And (0.68 ± 0.04) in control group were significantly lower than those in control group (0.83 ± 0.05), (0.74 ± 0.04) and (0.73 ± 0.03), respectively (P <0.05). Conclusions Compared with invasive mechanical ventilation, bi-level positive pressure noninvasive ventilation aids the treatment of severe acute left heart failure, which can reduce the cardiac load and improve the cardiac function of patients based on the assurance of effective ventilation.