早期使用双水平正压通气治疗急性左心衰竭疗效分析

目的 观察早期应用双水平正压无创通气(bilevel positive airway pressure,BiPAP)治疗急性左心衰竭的疗效.方法 选择2006年2月至2011年9月在心血管内科住院治疗的急性左心衰竭患者77例,随机分为BiPAP治疗组35例和常规治疗组42例.BiPAB治疗组急性左心衰竭患者30 min内开始使用BiPAP加药物治疗,并与常规药物治疗组进行比较.比较两组治疗1、24h后心率、呼吸频率、动脉血氧分压、脑钠肽水平及住院插管率、病死率.结果 BiPAP治疗组1、24h后心率、呼吸频率、动脉血氧分压、脑钠肽水平与治疗前比较差异均有统计学意义(P＜0.05).常规治疗组1h后脑钠肽水平与治疗前比较差异无统计学意义(P＞0.05).BiPAP治疗组较常规治疗组插管率明显减少(P＜0.05),病死率未见明显差异(P＞0.05).结论 早期应用BiPAP治疗急性左心衰竭可显著改善患者症状.

Effecttive analysis of early BiPAP application in treatment of acute left heart failure

Objective To observe the effect of early use of bilevel positive airway pressure(BiPAP) in the treatment of acute left heart failure.Methods 77 inpatients with acute left heart failure treated in the cardiological department of our hospital from February to September 2011 were selected.Among them,35 cases received BiPAP jointed with conventional medical treatment within 30 min after diagnosis and the other 42 cases were treated only with conventional medical treatment.The heart rate(HR),breathing rate(BR),artery blood oxygen partial pressure,BNP,tracheal intubation rate and mortality at 1,24 h after treatment were compared between 2 groups.Results Compared with before treatment in the BIPAP treatment group,HR,BR,artery blood oxygen partial pressure and BNP level were significantly improved at 1,24 h after treatment,showing statistical differences(all P<0.05).Compared with before treatment in the conventional treatment group,the BNP level had no statistical difference after 1 h treatment(P>0.05).Compared with the conventional treatment group,the tracheal intubation rate in the BiPAP treatment group was significantly reduced(P<0.05).The mortality rate had no significant difference(P>0.05).Conclusion Early application of BiPAP in the treatment of acute left heart failure can significantly improve the treatment effect.