无创正压通气在治疗急性左心衰竭中的应用观察

目的探讨无创正压通气呼吸机治疗急性左心衰竭(ALVF)患者的临床效果。方法将我院2010年3月~2012年3月收治的86例ALVF患者随机分为对照组和治疗组,各43例。对照组采用常规抗心衰的方法进行治疗;治疗组患者在对照组的基础上采用双水平气道正压通气(BiPAP)机械通气治疗,比较两组患者治疗前后血气分析情况及治疗的总有效率。结果治疗前两组患者动脉血气分析比较无统计学差异,治疗12 h后治疗组患者PaO2、PaCO2、pH基本恢复正常,与对照组比较有统计学差异(t=3.428、2.835、2.307,P<0.05)。对照组中痊愈13例,显效10例,有效7例,无效13例,总有效率为69.8%;治疗组中痊愈19例,显效13例,有效6例,无效5例,总有效率为88.4%,两组比较差异有统计学意义(P<0.05)。结论双水平气道正压通气(BiPAP)机械通气法治疗ALVF效果十分明显,值得临床进一步使用和推广。

Observation of noninvasive positive pressure ventilation in the treatment of acute left ventricular failure

Objective To explore the clinical effect of acute left ventricular failure with noninvasive positive pressure ven- tilator （ALVF）. Methods 86 cases of ALVF patients from my hospital in March 2010-2012 year in March were randomly divided into control and treatment group, each of 45 cases. Control group were used conventional methods of anti-heart failure treatment;the treatment of patients in the control group were used on the basis of bi-level positive airway pressure （BiPAP） treated with mechanical ventilation,two groups were compared blood gas analysis and treatment efficiency. Re- suits Before treatment,patients were arterial blood gas analysis showed no statistical difference in the treatment of 12 h in patients treated with the PaO2 PacO2,pH back to normal,compared with control group significant difference （t = 3.428,2.835,2.307,P 〈 0.05）. Control group of 43 cases, 13 cases were recovered, 10 cases markedly effective in 7 cases and 13 cases,the total effective rate was 69.8% ;treatment group were cured 19 cases, 13 cases markedly effective in 6 cases, 5 cases,the total effective rate was 88.4%, the difference was significant （P 〈 0.05）. Conclusion Bi-level positive airway pressure ventilation the mechanical ventilation France on ALVF patients the treatment effect is very obvious,it is worth further clinical use and promotion.