BiPAP无创通气治疗急性心肌梗死并发泵衰竭的临床疗效观察

目的：探讨急性心肌梗死(AMI)并发心源性休克或急性左心衰患者应用BiPAP呼吸机辅助通气后的临床疗效方法：对18例上述患者在常规药物治疗无效时加用BiPAP辅助通气，检测应用前后的血压、心率、呼吸与动脉血气等参数，观察其疗效。结果：18例中死亡2例(11．1％)，存活16例(88．9％)。其中经加用BiPAP辅助通气治疗后血压、心率与SaO2等均有明显改善。应用12～36h后．上述参数逐步改善直至恢复正常．持续应用时间为4～26d。病情缓解且稳定持续48h以上者可考虑逐步撤除呼吸机。结论：AMI并发心源性休克或急性左心衰在积极药物治疗基础上及早加用BiPAP呼吸机可明显减低死亡率。

The Clinical Outcome of BiPAP Ventilation in Acute Myocardial Infarction (AMI) Complicating Cardiac Pump Failure

Objective: To investigate the clinical outcome of AMI complicating with cardiac shock ( n =10)or acute left heart failure ( n =8 ) after using BiPAP respirator. Methods: Eighteen patients refractory to conventional medical the rapy were apphed with nomnvasive mechamcal ventilation by BiPAP respirator. Hemodynamic status, respiration and artery blood gas were measured before and post using respirator. Results: Of all 18 cases. 2 (11. 1 % ) died; 16 cases survived and were improved in symptom, blood pressure, heart rate and SaO2 significantly after using BiPAP ventilation. Most of them wire improved 12 36 h later after using BiPAP. BiPAP ventilation were removed gradually when clinical status and above parameters were improved markedly or became normal. Conclusion: AMI patients complicating cardiac shock or acute left heart fatlure treated with nomnva sive BiPNP ventilation may improve clinical symptoms and decrease in-hospital mortality significantly.