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目的探讨无创呼吸机治疗急性重症左心功能衰竭合并Ⅱ型呼吸衰竭的临床效果。方法选取成都市天府新区人民医院2013年9月—2015年9月收治的急性重症左心功能衰竭合并Ⅱ型呼吸衰竭患者82例,随机将患者分为对照组与研究组,各41例。在常规治疗基础上,对照组予以持续正压通气治疗,研究组予以无创正压通气治疗,比较两组患者治疗前后血气分析指标[血氧分压(PaO_2)、血二氧化碳分压(PaCO_2)、酸碱度(p H值)]、心功能指标[左心室射血分数(LVEF)、每搏输出量(SV)及心肌做功指数(MPI)]及并发症发生情况。结果治疗前两组患者PaO_2、PaCO_2、p H值比较,差异无统计学意义(P>0.05);治疗后研究组患者PaO_2高于对照组,PaCO_2低于对照组,p H值小于对照组(P<0.05)。治疗前两组患者LVEF、SV、MPI比较,差异无统计学意义(P>0.05);治疗后研究组患者LVEF、SV高于对照组,MPI低于对照组(P<0.05)。两组患者均未发生严重并发症。结论无创呼吸机治疗急性重症左心功能衰竭合并Ⅱ型呼吸衰竭的临床效果确切,可有效改善患者血气分析指标与心功能。
Objective To investigate the clinical effects of noninvasive ventilator in the treatment of acute severe left heart failure with type Ⅱ respiratory failure. Methods 82 patients with acute severe left heart failure and type Ⅱ respiratory failure admitted to Tianfu New District People’s Hospital of Chengdu from September 2013 to September 2015 were randomly divided into control group and study group, 41 cases in each group. On the basis of routine treatment, the control group was treated with continuous positive pressure ventilation. The study group was treated with noninvasive positive pressure ventilation. The blood gas analysis indexes (PaO 2, PaCO 2, (P H value)], cardiac function [LVEF, SV and MPI], and the incidence of complications. Results There was no significant difference in PaO_2, PaCO_2 and p H between the two groups before treatment (P> 0.05). After treatment, PaO_2 in the study group was higher than that in the control group, PaCO_2 was lower than that in the control group, p H value was lower than the control group P <0.05). There was no significant difference in LVEF, SV and MPI between the two groups before treatment (P> 0.05). After treatment, LVEF and SV of the study group were higher than those of the control group, and MPI was lower than the control group (P <0.05). No serious complications occurred in both groups. Conclusion Noninvasive ventilator is effective in treating acute severe left heart failure with type Ⅱ respiratory failure and can effectively improve the blood gas analysis index and cardiac function.