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目的探讨无创正压通气(NPPV)在治疗急性左心衰竭患者中的临床效果。方法将2013年9月-2014年7月收治的20例急性左心衰竭患者随机分为治疗组和对照组,每组各10例。两组患者均采用常规镇静、强心、利尿、扩血管等药物对症治疗,治疗组同时采用早期NPPV。观察两组患者治疗前以及治疗2 h后p H值、动脉血二氧化碳分压(Pa CO2)、动脉血氧分压(Pa O2)、心率(HR)、呼吸(R),入住重症监护病房(ICU)时间,有创通气时间,机械通气总时间和治疗成功例数。结果对照组治疗2 h后Pa O2(67.0±8.5)mm Hg(1 mm Hg=0.133 k Pa)、HR(124±10)次/min、R(34±4)次/min,入住ICU时间(6.0±1.1)d、有创通气时间(32±3.1)h、机械通气总时间(32.0±3.1)h;治疗组治疗2 h后Pa O2(82.3±8.9)mm Hg、HR(98±11)次/min、R(24±4)次/min,入住ICU时间(4.0±0.8)d、有创通气时间(16.0±1.3)h、机械通气总时间(26.0±1.8)h。两组患者各指标比较,差异均有统计学意义(P<0.05)。结论急性左心衰患竭者早期NPPV,对迅速缓解临床症状、降低医疗费用具有重要意义。
Objective To investigate the clinical effect of non-invasive positive pressure ventilation (NPPV) in the treatment of patients with acute left heart failure. Methods Twenty patients with acute left heart failure admitted from September 2013 to July 2014 were randomly divided into treatment group and control group, with 10 cases in each group. Two groups of patients were treated with conventional sedation, cardiac, diuretic, vasodilators and other drugs symptomatic treatment, the treatment group also adopted early NPPV. The levels of p H, PaCO 2, Pa O 2, HR, respiration (R) before treatment and 2 h after treatment were observed in two groups of patients and were admitted to intensive care unit ICU) time, invasive ventilation time, total duration of mechanical ventilation and the number of successful cases. Results PaO2 (67.0 ± 8.5) mm Hg (1 mm Hg = 0.133 k Pa), HR (124 ± 10) / min, R (34 ± 4) 6.0 ± 1.1) d, duration of invasive ventilation (32 ± 3.1) h and total mechanical ventilation time (32.0 ± 3.1) h. PaO2 of 82.3 ± 8.9 mm Hg and 98 ± 11% The time of ICU stay was (4.0 ± 0.8) d, the duration of invasive ventilation was (16.0 ± 1.3) h, and the total duration of mechanical ventilation was (26.0 ± 1.8) h. The two groups of patients with various indicators, the differences were statistically significant (P <0.05). Conclusions Early NPPV in patients with acute left heart failure is of great importance in rapidly relieving clinical symptoms and reducing medical expenses.