无创呼吸机在心衰救治中应用的临床价值探讨.doc

无创呼吸机在心衰中应用的探讨　摘要目的 无创呼吸机(BiPAP)救治急性左心衰竭的临床疗效探讨。方法　60例急性左心衰竭患者随机分为治疗组与对照组，治疗组30例，在常规抗心衰治疗基础上联用呼吸机面罩正压通气治疗，30例对照组为常规抗心衰治疗，测定治疗前后动脉血Ph、PaO2、PaCO2观察血压、心率、呼吸及临床症状，并进行分析。结果 治疗组治疗后Ph、PaO2、PaCO2、心率、呼吸、血压均较明显改善(0.05)，治疗显效，明显高于对照组(P0.05)；治疗组有效28例），对照组有效22例），有效率治疗组较对照组明显增高(0.05)。结论 无创呼吸机对急性左心衰的治疗有一定效果。 关键词急性左心衰双水平正压无创通气　　Treatment of acute heart failure with conventiona ltherapy and bi-level positive airway pressure 【Abstract】 Objective　To evaluate the therapeutic effects of bi-level positive airway pressure on acute left heart failure. Methods patients with acute left heart failure received combined conventional therapy and bi-level positive airway pressure, and were compared with30 patients with acute left heart failure receiving traditional treatment as controls. The changes in the power of hydrogen, partial pressure of oxygen in artery, pulse oxygen saturation, partial pressure of carbondioxide in artery, buffuerexcess, blood pressure, heart rate, and breathing frequency, and clinical symptom were compared between the two groups. Results　Compared with control group, the blood pressure, heart rate, breathing frequency decreased significantly (P 0.05 ) ;pulse oxygen saturation increased significantly (P 0.05 ); the power of hydrogen, partial pressure of oxygen in artery, partial pressure of carbondioxide in artery, and buffuer excess were improved more significantly (P 0.05 ) ; the marked response rate and the total effective rate increased significantly (P 0.05 ). Conclusions　The combined conventional therapy and bi-level positive airway pressure has a good efficacy in the patients with acute left heart failure. 【Keywords】　Acute left heart failure Bi-level positive airway pressure ; Therapeutic effect 　，，，[1]。BiPAP机械通气是经面罩双向正压持续通气，可改善心功能[]；本文收集我院60例急性左心衰。 　资料与方法 1.1　研究对象　选取2004年7月～2008年1月在我院诊治的60例急性左心衰患者。治疗组30例，男14例、女16例，平均年龄66.2岁，其中冠心病例(急性心肌梗死例，陈旧心肌梗死1例)，男、女各例高血压性心脏损害(高心病)例，男例，女例风湿性心脏病(风心病)6例，男2例，女4例扩张型心肌病(扩心病)例，均为女性。对照组:例同期住院急性左心衰竭患者，男例、女例，其平均年龄6岁，其中冠心病(急性心肌梗死5例，陈旧心肌梗死1例