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目的:探讨全封闭面罩接呼吸机无创正压通气在急性心功能不全时的治疗价值。方法:对45例急性心功能不全的患者,在常规抗心衰治疗的基础上加用全封闭面罩接呼吸机无创正压通气治疗,同时进行动脉血气、心率、呼吸频率等生命体征的检测和分析。结果:本组患者40例(89%),经全封闭面罩接呼吸机无创正压通气后,临床症状在30 min病情均有明显改善,心率、呼吸频率均显著低于治疗前(P<0.01);而动脉血氧饱和度(SaO2)均显著上升(P<0.01),6～24 h脱机,总有效率为89%。3例因为患者面罩密封性不好,呼吸机提示漏气严重,后改为气管插管有创机械通气进行抢救。2例急性左心衰并发慢性肺部阻塞性病变的患者使用呼吸机后出现动脉血二氧化碳分压(PaCO2)升高,出现神志模糊及呼吸暂停现象,停用呼吸机。结论:急性心功能不全伴低氧血症的患者,早期应用全封闭面罩接呼吸机无创正压通气能迅速纠治并改善心功能,并发症少,是一种安全有效的治疗方法。
Objective: To investigate the therapeutic value of non-invasive positive pressure ventilation in fully enclosed mask-connected ventilator in acute cardiac insufficiency. Methods: Forty-five patients with acute cardiac insufficiency were treated with noninvasive positive pressure ventilation with fully-enclosed mask-mounted ventilator on the basis of routine anti-heart failure treatment. At the same time, vital signs such as arterial blood gas, heart rate and respiratory rate were detected and analysis. Results: In 40 cases (89%) of the patients, the clinical symptoms improved significantly after 30 min, and heart rate and respiratory rate were significantly lower than those before treatment (P <0.01) ), While arterial oxygen saturation (SaO2) increased significantly (P <0.01). After 6-24 h, the total effective rate was 89%. 3 patients because the patient’s mask is not good sealing, ventilator prompt serious air leaks, tracheal intubation after mechanical ventilation to rescue. Two patients with acute left heart failure complicated with chronic obstructive pulmonary disease showed increased arterial carbon dioxide partial pressure (PaCO2) after using the ventilator, resulting in delirium and apnea, and disabling the ventilator. Conclusions: In patients with acute cardiac dysfunction and hypoxemia, early application of a fully closed mask-mounted ventilator with noninvasive positive pressure ventilation can promptly correct and improve cardiac function with fewer complications and is a safe and effective treatment.