无创呼吸机在并发呼吸衰竭的急性心衰患者中的临床价值研究

目的:对比分析无创呼吸机与常规对症治疗在并发呼吸衰竭的急性心衰(acute heart failure,AHF)患者中的临床疗效及价值。方法:分析在ICU接受治疗的400例并发呼吸衰竭的AHF患者的临床资料。随机将入选者分成观察组(无创呼吸机治疗)和对照组(常规对症治疗),每组200例。比较两组患者治疗前后的心率(HR)、呼吸频率(RR)及动脉血气情况(包括PaO_2、PaCO_2、pH值)变化、临床疗效及呼吸状况。结果:治疗后两组患者的HR、RR及PaO_2、PaCO_2、pH值均比治疗前有明显改善,且观察组患者的HR、RR及PaO_2、Pa CO_2、pH值改善情况均明显优于对照组(均P<0.05);观察组患者治疗后的总有效率(93.5%)高于对照组(74.0%)(χ2~=27.94,P<0.01);观察组患者的临床症状、活动影响、疾病影响及总分均明显比对照组低(均P<0.01)。结论:采用无创呼吸机治疗并发呼吸衰竭的AHF患者具有很好的临床疗效及预后,值得推广。

Study on the clinical value of non-invasive ventilator in the acute heart failure patients combined with respiratory failure

Objective:To compare and analyze the clinical efficacy and value of non-invasive ventilator and conventional symptomatic treatment in the acute heart failure(HF) patients combined with respiratory failure.Methods:Clinical data of 400 AHF patients combined with respiratory failure was retrospectively analyzed.Patients were randomly divided into the observation group (non-invasive ventilator) and control group (conventional symptomatic treatment),200 cases in each group.The values of HR,RR,PaO2,PaCO2,pH before and after treatment,the clinical efficacy and the breath state in two groups were compared.Results:After treatment,the value of HR,RR,PaO2,PaCO2,pH in two groups were all better than those before treatment and the improvement effect in observation group was better than that in control group (P ＜0.05).The total effective rate in observation group (93.5％) was obviously higher than that in control group (74.0％)(x2 =27.94,P ＜ 0.01).The clinical symptoms score,the activity score,the disease impact score and the total score in observe group were all obviously lower than those in control group (P ＜0.01).Conclusion:The clinical efficacy and prognosis of non-invasive ventilator in treating the AHF patients combined with respiratory failure is satisfactory,which is worth promoting.