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目的探讨无创正压通气在急性心肌梗死合并心力衰竭患者急救中的应用效果。方法 67例急性心肌梗死合并心力衰竭患者,在常规治疗的基础上联合应用无创正压通气治疗,比较患者治疗前、治疗24 h后动脉血气结果;比较治疗前、治疗48 h后B型脑钠肤(BNP)变化;比较治疗前、治疗1周射血分数(EF)的变化。结果经过无创通气治疗,治疗24h后动脉血氧分压(PO_2)由(67.1±8.12)mmHg(1mmHg=0.133 kPa)上升到(91.3±6.11)mmHg,差异有统计学意义(P<0.05);治疗48 h后BNP由(654.3±23.3)μmol/L下降到(235.6±20.4)μmol/L,差异具有统计学意义(P<0.05);治疗1周后射血分数由(35.2±11.3)%上升到(47.8±14.2)%,差异具有统计学意义(P<0.05)。结论急性心肌梗死合并心力衰竭患者早期行无创机械通气能迅速纠正低氧血症,提高患者心功能,改善预后。
Objective To investigate the effect of non-invasive positive pressure ventilation in the emergency treatment of patients with acute myocardial infarction complicated with heart failure. Methods Sixty-seven patients with acute myocardial infarction complicated with heart failure were treated with noninvasive positive pressure ventilation on the basis of routine treatment. The results of arterial blood gas 24 h after treatment were compared. Before treatment, B-type Na + (BNP). The changes of ejection fraction (EF) at 1 week after treatment were compared. Results After non - invasive ventilation, the PO2 increased from (67.1 ± 8.12) mmHg (1mmHg = 0.133 kPa) to (91.3 ± 6.11) mmHg after 24 - hour treatment, the difference was statistically significant (P <0.05). The BNP level decreased from (654.3 ± 23.3) μmol / L to (235.6 ± 20.4) μmol / L after 48 h treatment, with statistical significance (P <0.05). After one week, the ejection fraction increased from (35.2 ± 11.3) (47.8 ± 14.2)%, the difference was statistically significant (P <0.05). Conclusion Early non-invasive mechanical ventilation in patients with acute myocardial infarction complicated with heart failure can quickly correct hypoxemia, improve cardiac function and improve prognosis.