无创通气在急性左心衰并发低氧血症抢救中的应用

目的探讨无创机械通气在急性左心衰并发低氧血症抢救中的临床意义。方法对42例急性左心衰并发低氧血症的患者在常规内科治疗同时加用无创性经面罩机械通气(NIV)治疗,观察无创通气(NIV)前后患者呼吸指标、肺气体交换与心率(HR)、平均动脉压(MAP)的变化。结果42例患者均能耐受NIV治疗,临床症状明显改善,呼吸频率明显下降;与NIV治疗前相比,患者的动脉血中PH、氧分压(PaO_2)、二氧化碳分压(PaCO_2)、氧饱和度(SaO_2)等指标明显改善(P<0.05),HR与MAP明显减慢(P<0.05)。结论NIV治疗急性左心衰时能迅速改善患者的症状和低氧血症,是一种快速、安全、有效的方法,可避免气管插管。

Clinical application of non-invasive ventilation in the rescue of acute left heart failure complicated with hypoxemia

Objective To explore the clinical significance of non-invasive mechanical ventilation in the rescue of acute left heart failure complicated with hypoxemia.Methods Forty-two patients with acute left heart failure were treated with non-invasive me- chanical ventilation via face mask(BiPAP)in addition to conventional treatment.The changes of clinical symptoms and arterial blood gas indides(pH,PaO_2,PaCO_2,SaO_2)and heart rate together with mean arterial pressure were measured before and after treatment.Results NIV treatment was tolerable for all subjects.After non-invasive ventilation,the clinical symptoms of all pa- tients had been improved significantly(P<0.05).The clinical parameters showed statistical differences compared with those before non-invasive ventilation treatment(P<0.05).Conclusion Non-invasive ventilation can improve symptoms and hypoxemia in pa- tients with acute left heart failure and endotracheal intubation was avoided in the patients studied.It is a safe and effective method in treating acute left heart failure complicated with hypoxemia.