无创呼吸机治疗34例急性左心衰的疗效研究

目的观察无创呼吸机治疗急性左心衰竭的疗效。方法选择2009年1月～2011年12月我院急诊科抢救的急性左心衰患者68例，随机分为观察组及对照组，每组各34例；观察组给予无创呼吸机治疗，对照组给予传统治疗。比较两组患者的动脉血气、临床疗效和并发症情况。结果观察组治疗后氧分压（PaO2）、二氧化碳分压（PaCO2）、血氧饱和度（SpO2）较治疗前显著改善，而静息心率（HR）、呼吸频率（RR）较治疗前显著下降，差异均有统计学意义（均P〈0．05）。对照组PaO2、SaO2较治疗前显著升高，差异有统计学意义（P〈0．05），其余指标与治疗前比较差异无统计学意义（P〉0．05）。观察组和对照组治疗后PaO2、HR、RR和SaO2比较，观察组治疗后效果显著优于对照组，差异有统计学意义（P〈0．05）。观察组治疗总有效率（91．2％）显著优于对照组（70．6％），差异有统计学意义（χ2=4．66，P=0．0321）；观察组再住院率和心脏事件发生率显著低于对照组，差异有统计学意义（P〈0．05）。结论无创呼吸机通气治疗急性左心衰竭安全、有效，能显著改善患者的动脉血气情况，提高治疗有效率，降低并发症发生率。

Curative effect research of noninvasive ventilator on 34 patients with acute left heart failure

Objective To observe the curative effect of noninvasive ventilator on acute left heart failure. Methods 68 patients with acute left heart failure from January 2009 to December 2011 in our hospital were selected and divided into observation group and control group with 34 cases in each group; the patients in observation group were treated with noninvasive ventilator therapy, the patients in control group were treated with traditional therapy. Arterial blood gases, clinical efficacy and complications in the two groups were compared. Results PaO2, PaCO2 and SpO2 in observa- tion group after the treatment were higher than those before the treatment, HR and RR in observation group after the treatment were lower than those before the treatment, the differences were all statistically significant （all P 〈 0.05）. PaO2 and SaO2 in control group after the treatment were lower than those before the treatment, the differences were all statistically significant （all P 〈 0.05）, the differences of the rest of the indexes before and after the treatment were all not statistically significant （P 〉 0.05）. PaO2, HR, RR and SaO2 in observation group after the treatment were all better than those in control group, the differences were all statistically significant （all P 〈 0.05）. The total effective rate in observation group （91.2%） was better than that in control group （70.6%）, the difference was statistically significant （χ2 = 4.66,P = 0.032 1）; rehospitalization rate and major adverse cardiovascular events rate in observation group were lower than those in control group, the differences were all statistically significant （all P 〈 0.05）. Conclusion Noninva- sive ventilator in the treatment of acute left heart failure is safe, effective and can significantly improve the patients arterial blood gas situation, enhance the treatment efficiency and reduce the incidence of complications.