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目的探讨吗啡联合无创呼吸机正压通气治疗急性左心衰竭的临床疗效。方法选取2013年2月—2015年1月陕西省核工业二一五医院收治的急性左心衰竭患者70例,采用完全随机数表法分为对照组和观察组,各35例。在基础治疗和常规抗心力衰竭治疗基础上,对照组患者给予无创呼吸机正压通气治疗,观察组患者给予吗啡联合无创呼吸机正压通气治疗,比较两组患者呼吸频率、心率、心肌耗氧量、氧合指数、尿量、血清脑钠肽(BNP)水平、急性生理与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分及临床疗效。结果治疗前两组患者呼吸频率、心率、心肌耗氧量、氧合指数、血清BNP水平、APACHEⅡ评分及尿量比较,差异无统计学意义(P>0.05);治疗后观察组患者呼吸频率、心率、心肌耗氧量、BNP及APACHEⅡ评分低于对照组,氧合指数和尿量高于对照组(P<0.05)。观察组患者的临床疗效优于对照组(P<0.05)。结论吗啡联合无创呼吸机正压通气可有效改善患者临床症状,且临床疗效确切。
Objective To investigate the clinical efficacy of morphine combined with noninvasive ventilator positive pressure ventilation in the treatment of acute left heart failure. Methods Seventy patients with acute left heart failure who were treated in Nuclear Industry 215 Hospital of Shaanxi Province from February 2013 to January 2015 were randomly divided into control group and observation group with 35 cases in each group. On the basis of basic treatment and routine anti-heart failure treatment, patients in the control group were treated with noninvasive ventilator positive pressure ventilation. Patients in the observation group were given morphine plus noninvasive ventilator positive pressure ventilation. The respiratory rate, heart rate, myocardial oxygen consumption Volume, oxygenation index, urine output, serum brain natriuretic peptide (BNP) level, acute physiology and chronic health status score system Ⅱ (APACHE Ⅱ) score and clinical efficacy. Results There was no significant difference in respiration frequency, heart rate, myocardial oxygen consumption, oxygenation index, serum BNP level, APACHEⅡscore and urine output in the two groups before treatment (P> 0.05). After treatment, the respiratory rate, Heart rate, myocardial oxygen consumption, BNP and APACHE Ⅱ score lower than the control group, oxygenation index and urine output was higher than the control group (P <0.05). The clinical efficacy of the observation group was better than that of the control group (P <0.05). Conclusion Morphine combined with non-invasive ventilator positive pressure ventilation can effectively improve the clinical symptoms of patients, and the clinical curative effect is exact.