无创正压通气治疗应用于重度急性左心衰合并 II 型呼吸衰竭抢救的疗效观察

目的：探讨无创正压通气治疗应用于重度急性左心衰合并 II 型呼吸衰竭抢救的临床疗效。方法：收集2014年1月至2015年5月期间我院重度急性左心衰合并 II 型呼吸衰竭患者84例，根据随机数字法，将其分为对照组（持续正压通气）和观察组（无创正压通气），每组各42例。比较治疗前后两组血压（SBP、DBP）、心率（HR）、呼吸频率，K ＋、Na ＋、血气分析（PaO2、PaCO2）及心功能指标（左室射血分数（LVEF）、每搏输出量（SV）、心肌作功指数（TEI））变化情况。结果：与对照组相比，观察组治疗后 SBP、DBP、HR、呼吸频率均明显降低，P ＜0．05；与对照组相比，观察组治疗后 K ＋、Na ＋水平均显著降低，PaO2明显增高，PaCO2显著降低，P ＜0．05；与对照组相比，观察组治疗后 LVEF、SV 均明显增高，TEI 显著降低，P ＜0．05。结论：无创正压通气治疗能够明显改善重度急性左心衰合并 II 型呼吸衰竭患者的缺氧症状及心功能，值得临床推广。

The efficacy observation of non-invasive positive pressure ventilation in the emergency treatment of severe acute left heart failure complicated with type II respiratory failure

Objective:To study the clinical efficacy of non-invasive positive pressure ventilation in the emergency treatment of severe acute left heart failure complicated with type II respiratory failure.Methods:The 84 patients with severe acute left heart failure complicated with type II respiratory failure in our hospital during the period from Jan 2014 to May 2015 were randomized into the control group (continuous positive airway pressure)and the observation group (non-invasive positive pressure ventilation)according to the random number method,42 patients per group.The changes of pressure (systolic blood pressure (SBP)and diastolic blood pressure (DBP)),heart rate (HR),respiratory frequency,the level changes of K + and Na +,the changes of blood gas analysis (arterial oxy-gen partial pressure (PaO2 )and carbon dioxide oxygen partial pressure (PaCO2 ))and heart function (left ventricular ejection fraction (LVEF),stroke volume (SV),and total ejection isovolume (TEI))on pre-and post-treatment in the two groups.Results:Compared with the control group,the SBP,DBP,HR,respiratory frequency were significantly decreased on post-treatment in the observation group (P <0.05);compared with the control group,the levels of K + and Na + were obviously reduced on post-treatment,and the PaO2 was obviously increased and the PaCO2 was significantly decreased in the observation group (P <0.05);compared with the control group, the LVEF and SV were significantly improved and the TEI was obviously decreased on post-treatment in the observation group (P <0. 05 ).Conclusion:The emergency treatment of non-invasive positive pressure ventilation can significantly improve the hypoxia symptoms and heart function for patients with severe acute left heart failure complicated with type II respiratory failure,and is worthy of clinical promotion.