急性左心衰患者应用呼气末正压通气的治疗效果分析

目的探讨调节呼吸末正压通气(PEEP)水平对急性左心衰疗效及预后的影响。方法将49例急性左心衰患者随机分为2组,对照组(n=22)在常规药物治疗基础上加用低水平PEEP(<5 cmH2O),治疗组(n=27)在常规药物治疗基础上加用较高水平PEEP(5~10cmH2O),记录2组治疗前、治疗后2 h及治疗后8 h的血压、心率、氧合指数(PaO2/FiO2)、二氧化碳分压(PaCO2),观察疗效。结果 2组治疗后1 d及2 h血压、心率、PaO2/FiO2、PaCO2均较治疗前显著改善(P<0.01),治疗组各指标改善情况优于对照组(P<0.05或P<0.01)。结论较高水平的PEEP有利于急性左心衰的治疗。

Efficacy of positive end-expiratory pressure (PEEP) mechanical ventilation in the treatment of acute left heart failure

Objective To explore the efficacy of positive end-expiratory pressure(PEEP) level on acute left heart failure(ALHF) and its influence on prognosis.Methods Forty-nine ALHF patients were randomly divided into two groups.The control group(n=22) received a low level of PEEP(<5 cmH2O) in addition to a routine treatment,while the treatment group(n=27) received a high level of PEEP(5-10 cmH2O) in addition to a routine treatment.The blood pressure,heart rate,oxygen and index(PaO2/FiO2),partial pressure of carbon dioxide(PaCO2) of the two groups before,2 h and 8 h after treatment were recorded to observe the clinical efficacy.Results The levels of blood pressure,heart rate,PaO2/FiO2 and PaCO2 in both two groups 1 d and 2 h after the treatment all improved(P<0.01).The improvements of indicators were better in the treatment group than in the control group(P<0.05 or P<0.01).Conclusion Higher level of PEEP is effective in the treatment of ALHF.