无创辅助通气治疗老年急性左心衰的疗效

目的：评价双水平正压（bilevel positive airway pressure，BiPAP）通气治疗急性左心衰的安全性及有效性。方法：对各种原因出现的急性左心衰患者随机分成常规治疗组和BiPAP通气治疗组（简称BiPAP组），比较两组治疗效果及合并症。结果：较之常规治疗组，BiPAP组的脉搏氧饱和度[SpO2，（84±10）％：（95±5）％，P=0．039]；动脉血氧分压[PaO2，（63±12）mmHg：（86±8）mmHg，P=0．043]显著增加，治疗后30min的呼吸频率[（36±5）次／min：（22±7）次／min，P=0．016]和心率[（133±19）次／min：（110±17）次／min，P=0．038]显著减少；2／3水泡音消失时间[（18±8．9）h：（5±8．3）h，P=0．034]和住院时间[（18±3．2）d：（10±4．3）d，P=0．045]显著缩短；需急症气管插管的人数（9：1，P=0．048）显著减少，无严重副作用发生。结论：双水平正压通气治疗急性左心衰安全、有效。

Efficiency and safety of noninvasive assistant bilevel positive airway pressure ventilation treating old patients with acute left heart failure

Objective： To evaluate the efficiency and safety of noninvasive assistant bilevel positive airway pressure （BiPAP） ventilation treating old patients with acute left heart fallure. Methods： Overall 63 patients with acute left heart failure and acute pulmonary edema were randomly divided into BiPAP group （24 cases, treated with routine therapy and BiPAP at proper time） and control group （39 cases, treated with routine therapy）. The therapeutic efficacy between two groups was compared. Results： Compared with control group the blood gases [SpO2 , （84± 10）%vs. （95 ±5） %. P=0.039]; [PaO2. （63±12） mmHg vs. （86±8） mmHg, P=0.043] significantly increased; respiratory rate [ （36±5） breaths/min vs. （22±7） breaths/min, P=0. 016] and heart rate [ （133±19） beats/ rain vs. （110± 17） beats/ min, P= 0. 038] significantly decreased at 30 minutes after treatment, the resolution time [（18± 8.9） h vs. （5±8. 3） h, Y=0. 034] and the total time of hospital stay [（18±3. 2） d vs. （10±4.3） d, P=0. 045] shorten more, persons need for emergency endotracheal intubation （9 vs. 1, P=0. 048） significantly decreased in Bi- PAP group. No secondary effect was observed. Conclusion： Noninvasive bilevel positive airway pressure ventilation treatment is efficiency and safety for old patients with acute left heart failure and acute pulmonary edema.