双水平气道内正压通气在急性左心衰竭患者初始治疗中的应用
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摘要
目的观察双水平气道内正压通气(BiPAP)在急性左心衰竭(ALVF)初始治疗中的临床疗效。方法 78例ALVF患者随机分为观察组和对照组,两组采用相同的常规药物治疗,观察组加用BiPAP。观察两组患者治疗前及治疗后1h临床症状、血气分析和24h血浆脑利钠肽(BNP)水平变化。结果治疗后1h,观察组PaO2与PO2/FiO2较对照组高,而呼吸频率减少(P<0.05)。治疗后24h,两组患者血浆BNP水平均较治疗前下降(P<0.05),但观察组下降更显著(P<0.05)。结论 ALVF患者在初始治疗中使用BiPAP,可迅速改善临床症状和低氧血症,降低血浆BNP水平。
Objective To observe the clinical effect of bi-level positive airway pressure ventilation (BiPAP) on the initial treatment of acute left ventricular failure (ALVF). Methods Seventy-eight ALVF patients were divided into observation group (n=39) and control group (n=39). Both groups received the same conventional drug therapy, but BiPAP was added in observation group. Clinical symptoms and blood gas analysis were recorded at 1 h, and plasma brain natriuretic peptide (BNP) level was detected at 24 h after treatment in both groups. Results Compared with control group, PaO2与 PO2/FiO2 increased but respiratory rate decreased at 1 h in observation group (P<0.05). BNP level decreased at 24 h in both groups, especially in observation group (P<0.05). Conclusion BiPAP can rapidly improve the clinical symptoms and hypoxemia and reduce plasma BNP level in the initial treatment of ALVF patients.
Objective To observe the clinical effect of bi-level positive airway pressure ventilation (BiPAP) on the initial treatment of acute left ventricular failure (ALVF). Methods Seventy-eight ALVF patients were divided into observation group (n=39) and control group (n=39). Both groups received the same conventional drug therapy, but BiPAP was added in observation group. Clinical symptoms and blood gas analysis were recorded at 1 h, and plasma brain natriuretic peptide (BNP) level was detected at 24 h after treatment in both groups. Results Compared with control group, PaO2与 PO2/FiO2 increased but respiratory rate decreased at 1 h in observation group (P<0.05). BNP level decreased at 24 h in both groups, especially in observation group (P<0.05). Conclusion BiPAP can rapidly improve the clinical symptoms and hypoxemia and reduce plasma BNP level in the initial treatment of ALVF patients.
引文
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[4]王长远,秦俭.无创正压通气的临床应用及其进展[J].中国误诊学杂志,2008,8(1):21.
[5]叶绍东,张健.双水平正压通气治疗急性心源性肺水肿[J].国外医学·心血管疾病分册,2005,32(11):353-355.
[6]中华医学会心血管病学分会.急性心力衰竭诊断和治疗指南[J].中国心血管病研究,2011,9(2):81-97.