BiPAP对急性左心衰竭合并低血压疗效观察

目的：探讨BiPAP对急性左心衰竭合并低血压有效性。方法：64例急性左心衰合并低血压患者，按照随机数字表法分为治疗组和对照组，每组32例，治疗组采用BiPAP及药物治疗，对照组采用鼻导管及药物治疗，观察治疗前后收缩压、动脉血气分析、NT-proBNP水平。结果：（1）两组患者经治疗24 h后心衰症状均缓解，但1 h后治疗组指尖血氧饱和度更快恢复正常水平（P〈0.05）。（2）治疗组在治疗后1 h心率、收缩压恢复正常，与对照组比较差异有统计学意义（P〈0.05）。24 h两组NT-proBNP下降，两组比较差异有统计学意义（P〈0.05）。（3）1 h后治疗组动脉血氧分压显著升高，两组比较差异有统计学意义（P〈0.05）。结论：联合BiPAP能迅速缓解急性左心衰合并低血压临床症状，未见血压进一步下降。

The Clinical Effect of BiPAP on Patients with Acute Left Ventricular Failure and Hypotension

Objective：To observe the effect of bi-level positive airway pressure（BiPAP）on patients with acute left ventricular failure and hypotension. Method：Sixty-four patients with acute left ventricular failure and hypotension were randomly divided into control group（32 cases）and treatment group（32 cases）. The control group received the conventional drug therapy,and the treatment group was treated with BiPAP in addition. The changes of systolic blood pressure（SBP）, artery blood gas,and N-terminal pro-brain natriuretic peptide（NT-proBNP）in two groups were observed in 0 h,1 h,24 h after hospitalized. Result：（1）Clinic symptoms of all patients were improved,but the finger tip oxygen saturation was significant elevator after 1 hour in treatment group,quantitative value of treatment group was higher than that of the control group（P＆lt;0.05）.（2）Level of heart rate and systolic blood pressure was rapidly recovery after 1 hour,there was significantly difference between the two groups,level of NT-proBNP gradually decreased after 24 hour treatment,there was significant difference between the two groups（P＆lt;0.05）.（3）Arterial partial pressure of oxygen（PaO2）significantly increased after 1 hour treatment（P＆lt;0.05）,it was significantly different between the two groups. Conclusion：The symptoms are rapidly relieve in acute left ventricular failure and hypotension combination with BiPAP,phenomenon of hypotension is not happen further by using BiPAP.