机械通气对急性左心衰竭并呼吸衰竭患者病死率的影响

目的探讨急性左心衰竭并呼吸衰竭时应用机械通气治疗对患者病死率的影响。方法对45例急性左心衰竭并呼吸衰竭的患者,根据是否应用机械通气辅助呼吸分为治疗组和常规组,观察治疗24h后两组患者的血气分析指标、氧合指数、左室射血分数(LVEF)变化及28d病死率。结果(1)治疗组患者机械通气24h后PaO2、PaCO2及氧合指数较常规组改善,差异有统计学意义,P<0.05。(2)血pH值、LVEF较常规组亦有所改善,但差异无统计学意义,P>0.05。(3)28d病死率治疗组较常规组低,差异有统计学意义,P<0.05。结论机械通气治疗能改善急性左心衰竭并呼吸衰竭患者的氧合状态,降低病死率。

Effect of mechanical ventilation on mortality rate in patients with acute left ventricular failure and respiratory failure

Objective To investigate the effect of mechanical ventilation on mortality rate in patients with acute left ventricular failure and respiratory failure. Methods Forty-five patients with acute left ventricular failure and respiratory failure were divided into two groups: the group of routine treatment (routine group, n=19) and the group of routine treatment with mechanical ventilation (treatment group, n=26). Observe the changes of blood gas analysis, the ratio of the partial pressure of arterial oxygen to the fraction of oxygen in inspired gas (PaO_2/FiO_2) and left ventricular ejection fraction (LVEF) in 24 hours, and mortality rate on the 28th day. Results (1)The improvements of the partial pressure of arterial oxygen(PaO_2),the partial pressure of arterial carbon dioxide(PaCO_2) and ratio of the partial pressure of arterial oxygen to the fraction of oxygen in inspired gas (PaO_2/FiO_2) in the treatment group were greater than that in the routine group after 24 hours(P<0.05).(2) The improvements of LVEF in the treatment group was greater than that in the routine group after 24 hours, but the difference was not significant (P>0.05). (3) The mortality rate on the 28th day in treatment group was lower than that in routine group (P<0.05). Conclusions Mechanical ventilation treatment can improve the oxygenation status and decrease mortality rate of patients with acute left ventricular failure and respiratory failure.