分析双水平无创正压通气在抢救急性重度左心衰伴Ⅱ型呼吸衰竭中的应用效果研究

目的：分析双水平无创正压通气在抢救急性重度左心衰伴Ⅱ型呼吸衰竭中的应用效果。方法整群选取2015年1月—2016年2月在该院住院治疗的68例急性重度左心衰伴Ⅱ型呼吸衰竭病人随机分为实验组及对照组，每组34例患者，对照组于鼻部置入导管实施供氧处理。实验组采用呼吸机经鼻面罩上水平无创正压通气，统计分析两组研究对象治疗前后的RR、SBP、DBP、pH值、DO2、VO2、PaO2、Tei、LVEF、SV、BNP、K+、Na+的变化情况。结果验组患者治疗后患者的RR、SBP、DBP、心率分别为（19.5±5.9）次/min、（122.1±11.5）mmHg、（72.5±12.1）mmHg、（91.5±22.9）次/min，对照组分别为（25.4±9.1)次/min、（134.7±13.2）mmHg、（83.7±14.7）mmHg、（105.4±24.4）次/min，两组比较差异具有统计学意义（P<0.05）；实验组患者的pH、DO2、VO2、PaO2治疗后分别为（7.36±0.21）、（456.23±21.52）mL/min、（194.25±12.11）mL/min、（85.13±10.25）%，对照组分别为（7.25±0.17）、（334.71±15.87）mL/min、（157.54±13.25）mL/min、（62.54±11.35）%，两组比较差异具有统计学意义（P<0.05）；实验组患者的Tei指数、SV、LVEF治疗后分别为（0.64±0.03）、（50.01±2.07）%、（80.07±14.51）mL，对照组分别为（0.80±0.11）、（42.27±3.95）%、（70.29±13.67）mL，两组比较差异具有统计学意义（P<0.05）；实验组患者的BNP、K+浓度、Na+浓度分别为（528.24±35.14）pg/mL、（3.64±0.24）mmol/L、（133.25±4.23）mmol/L，对照组分别为（1432.87±22.74）pg/mL、（3.43±0.15）mmol/L、（143.51±4.89）mmol/L，两组比较差异具有统计学意义（P<0.05）。结论过双水平无创正压通气对急性重度左心衰伴Ⅱ型呼吸衰竭的病人开展抢救治疗，既能改善病人的各项指标情况，又能显著提升预后质量。

Study on the Effect of Non Invasive Positive Pressure Ventilation in the Treatment of Acute Severe Left Heart Failure with Type

Objective Analysis of bi level noninvasive positive pressure ventilation in treatment of severe acute left heart failure with type II respiratory failure in the application effect. Methods Group choose January 2015 to February 2016 in our hospital inpatient treatment of 68 cases of severe acute left heart failure with type II respiratory failure patients were randomly divided into experimental group and control group give out the object of selection time, specific to the month, and the corresponding English abstract modified]. Each group consisted of 34 patients, and the control group in the nasal catheter oxygen treatment. In the experimental group, the level of noninvasive positive pressure ventilation through the nasal mask was given two groups of treatment methods, and in the corresponding English summary to be modified,Statistical anal-ysis of the two groups before and after the treatment of RR, SBP, DBP, pH value, DO2, VO2, PaO2, Tei, LVEF, SV, BNP, K+, Na+changes. Results Patients in the experimental group after treatment in patients with RR and SBP, DBP, HR, respective-ly (19.5 ±5.9)times/min, (122.1 ±11.5)mmHg, (72.5 ±12.1)mmHg, (91.5 ± 22.9)times/min, control group were (25.4 ± 9.1)times/min, (134.7±13.2)mmHg, (83.7±14.7)mmHg, (105.4±24.4)times/min, the difference between the two groups has statistical significance (P< 0.05);Patients in the experimental group PH, DO2, VO2, PaO2 after treatment were (7.36±0.21), (456.23 ±21.52)mL/min, (194.25 ±12.11)mL/min, (85.13 ±10.25)%, the control group were (7.25 ±0.17), (334.71 ± 15.87)mL/min,(157.54± 13.25)mL/min,(62.54± 11.35)%, with significant differences between the two groups (P<0.05); ex-perimental group with the Tei index, SV and LVEF after treatment were (0.64±0.03),(50.01±2.07)%,(80.07±14.51)mL, the control group were (0.80±0.11), (42.27±3.95)%, (70.29±13.67)mL, with significant differences between the two groups (P<0.05); the experimental group of patients with BNP, K+ and Na+ concentration respectively. (528.24 ±35.14)pg/mL, (3.64 ± 0.24)mmol/L, (133.25±4.23)mmol/L, the control group were (1432.87±22.74)pg/mL, (3.43± 0.15)mmol/L,(143.5±4.89) mmol/L, with significant differences between the two groups (P<0.05). Conclusion Patients with acute severe left heart failure with type II respiratory failure were treated by bi level noninvasive positive pressure ventilation, which can not only improve the indicators of patients, but also significantly improve the prognosis of patients with acute left heart failure.