无创正压通气治疗急性冠脉综合征并发急性左心衰疗效评价

目的 评价无创正压通气治疗急性冠脉综合征合并急性左心衰疗效.方法 对16例急性冠脉综合征合并急性左心衰常规治疗30min不改善者选用无创正压通气治疗,观察通气前后临床症状和心功能、相关指标变化,并作统计学处理和分析.结果 15例患者经无创正压通气治疗45min～2h后,临床症状和心功能明显改善.心率、呼吸频率、血压、pH 、PO2、氧合指数等指标治疗前后差异均有统计学意义(P＜0.001),仅1例患者因合并严重肺部感染治疗无效,总有效率为93.7%.结论 在控制适当压力水平、维持血液动力学稳定前提下,无创正压通气治疗急性冠脉综合征合并急性左心衰是有效且较安全的.

Clinical efficacy evaluation of non-invasive positive pressure ventilation on acute coronary syndrome accompanied by acute left heart failure

Objective To evaluate the clinical efficacy of non-invasive positive pressure ventilation (NIPPV) in the treatment of acute coronary syndrome(ACS) accompanied by acute left heart failure.Methods Sixteen patients with ACS accompanied by acute left heart failure who had not response to the routine treatment in 30min received NIPPV.Before and after treatment the changes of clinical symptoms and related parameters were monitored and analyzed statistically.Results After treatment with NIPPV for 45min to 2h,the clinical symptoms and cardiac function were improved significantly in 15 patients . The clinical parameters(HR,RR,SBP,DBP) and arterial blood gas parameters (pH,PaO2, PO2/FiO2)showed significant differences compared with those before treatment(P<0.001).One patient was ineffective because of severe infection in lungs. The effective rate was 93.7%.Conclusion NIPPV on ACS with acute left failure is effective and safe when keeping a stable hemodynamics and a appropriate pressure support level.