老年重症心衰无创机械通气的应用

目的总结探讨无创机械通气治疗老年严重急性心力衰竭的疗效及临床价值。方法52例于2006年6月至2008年1月在我院住院治疗的老年重症急性心衰合并呼吸衰竭患者,随机分为常规治疗组（药物治疗及氧疗）和无创通气组。无创通气组在常规治疗基础上加用机械通气治疗。观察二组患者在治疗前后心率（HR）、呼吸频率（RR）、平均动脉压（MAP）、血气分析（pH、PaO2、PaCO2、SaO2）及临床症状改善情况。结果机械通气治疗后,患者呼吸困难明显改善,生命体征很快稳定,血气分析指标治疗明显好转。治疗组有效率明显高于对照组,病死率明显低于对照组（P〈0.05）,好转时间明显少于对照组（P〈0.05）,机械通气前后血气改善明显（P〈0.05）。结论对急性心力衰竭,机械通气能及时有效地改善患者的临床症状及低氧血症,是抢救急性心力衰竭合并呼吸衰竭的有效辅助措施。

Clinical Observation on Treatment of Serious Heart Fai lure with Mechanical Ventilation

Objective To study the curative effect of treatment of serious Heart Failure with mechanical ventilation.Method 52 patients with acute heart failure were devided into two groups, the conventional therapy group (medicine and oxygen therapist) and the non-invasive ventilation group. The second group were treated with conventional therapy and mechanical ventilation. The heart rate, respiratory rate and blood gas capacity for urine and the improving of clinical symptom were recorded and compared between the two groups. Result the patients with mechanical ventilation were improved clearly, and major signs stabilized quickly, and blood gas were improved too. Conclusion To the patient of serious heart failure, mechanical ventilation can improve clinical symptom and symptom of lower oxygen. Mechanical ventilation is a supplementary effective measure to serious heart failure patient.