无创机械通气治疗老年急性左心衰竭的疗效观察

目的探讨无创机械通气对老年急性左心衰竭患者的治疗效果及副反应。方法将42例符合入选标准的老年急性左心衰竭患者随机分为两组，对照组（19例）给予高浓度面罩酒精吸氧、常规强心、利尿、扩管、镇静治疗；治疗组（23例）在常规治疗的基础上，行双水平气道正压通气呼吸机辅助通气。观察两组患者治疗前后临床症状的改善情况，并监测患者治疗前及治疗后2小时动脉血气指标和心率、呼吸频率、射血分数、氧合指数，比较两组患者治疗结束时的病死率及气管插管率。结果治疗组治疗2小时后，患者临床症状迅速缓解，动脉血气指标和心率、呼吸频率、射血分数、氧合指数均明显改善，气管插管率及病死率较对照组低，两组比较差异有显著性（P〈0．05）。结论无创机械通气治疗老年急性左心衰竭起效迅速，能迅速纠正缺氧，改善心肺功能，减少气管插管率及病死率，副反应少，可作为抢救急性左心衰竭的重要手段之一。

The study of effect of Non - invasive mechanical ventilation in the treatment of old age acute left heart failure

Objective To discuss the effect and side reaction of Non-invasive mechanical ventilation（NPPV） in the old age acute left heart failure. Method 42 patients of old age acute left heart failure selected were divide into two groups randomly, Besides routine strengthening heart contraction, using diuresis,ectasying vessel and mitigating emotion to reduces the heart load to treat acute left heart failure, the 19 examples of control group were also given the highly concentrated face guard ethyl alcohol oxygent. While 23 examples of the treatment group were given the BiPAP life - support machine auxiliary ventilation. Then to observe the Improvement in symptomsof the two group of patients before and after treatment, detect 2 hour artery vigor index, heart rate, HR, respiratory rate RR, ejection fraction, EF, oxygenation index PaOJ FiO2 of the two groups of patients, and compare the mortality and the rate of endotracheal intubation of the end of the treatment. Result NPPV treatment can improve clinical symptoms,it can increase artery vigor index,heart rate, HR, respiratory rate RR, ejection fraction, EF, oxygenation index PaO2/FiO2 , it can reduce the mortality and the rate of endotracheal intubation. Conclusion NPPV can correct hypoxia, improve cardio-pulmonary function, reduce the mortality and the rate of endotracheal intubation. That is why using NPPV to cure the old age acute left heart failure is an effect method. It can be used as emergency treatment of acute left ventricular failure of one of the means.