无创双水平正压通气治疗慢性阻塞性肺疾病合并急性左心衰的疗效观察

目的观察无创双水平气道正压通气治疗慢性阻塞性肺疾病（COPD）合并急性左心衰竭的疗效。方法将40例COPD合并急性左心衰竭患者随机分为两组：对照组用常规治疗；治疗组在常规治疗同时加用无创双水平气道正压通气。观察治疗前后动脉血气分析、左心室射血分数（LVEF）变化及患者的临床变化。结果治疗组经无创双水平气道正压通气后患者呼吸频率减慢，心率下降，呼吸困难缓解，LVEF增加，总有效率90％；对照组总有效率仅55％，两组比较差异有统计学意义（P〈0．05）。结论无创双水平气道正压通气是治疗COPD合并急性左心衰竭快速有效的方法。

Clinical efficacy of noninvasive bi-level positive pressure ventilation in COPD and acute left heart failure

Objective To observe noninvasive bi-level positive pressure ventilation for the treatment of chronic obstructive pulmonary disease(COPD) with acute left heart failure. Methods 40 patients with COPD and a-cute left heart failure who were randomly divided into treatment group( n = 20) and control group.were treated with noninvasive bi-level positive pressure ventilation. Arterial blood gases, respiratory rate(RR), heart rate, blood pressure,and left ventricular ejection fraction(LVEF) were measured after therapy. Results Dyspnea was relieved in all patients in treatment group,both the respiratory rate and heart rate were slowed,the effective rate was 90% . While the total effect rate was only 55% in control group. LVEF was significantly higher in treatment group than control group(P< 0. 05). Conclusion The use of noninvasive bi-levcl positive pressure ventilation therapy is feasible and effective on COPD and acute left heart failure.