无创呼吸机联合管道雾化吸入治疗急性左心衰竭的疗效观察
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摘要
目的探讨无创呼吸机联合管道雾化吸入治疗急性左心衰竭的临床疗效。方法 2016年4月～2018年3月在开平市中心医院急诊科就诊的80例急性左心衰竭患者,随机分为对照组和治疗组,各40例。两组均给予常规治疗,如吸氧、强心、利尿、扩血管、平喘、改善循环、对症支持等,治疗组在常规治疗基础上加用无创呼吸机联合管道雾化吸入普米克令舒。两组均连续治疗至患者症状缓解,比较治疗前后临床症状、N-末端脑钠肽前体(NT-proBNP)、左室射血分数(LVEF)和左室舒张期E峰/A峰(E/A)比值、心率(HR)、呼吸频率(RR)、氧分压(PaO2)、氧饱和度(SatO2)、氧合指数(PaO2/FiO2)、症状缓解时间等。结果各组治疗后治疗组治疗效果较对照组更为明显(P<0.05)。结论无创呼吸机联合管道雾化吸入治疗急性左心衰竭比常规治疗临床效果更显著、更能缩短症状缓解时间、更能缩短病程、改善患者生活质量,并有良好的耐受性。
Objective To explore the clinical efficacy of non-invasive ventilator combined with pipeline atomization inhalation in the treatment of acute left heart failure.Methods Eighty patients with acute left heart failure who were admitted to the Emergency Department of Kaiping Central Hospital from April 2016 to March 2018 were randomly divided into two groups,the control group and the treatment group,40 cases in each group.Both groups were given routine treatment,such as oxygen inhalation,cardiotonic,diuretic,vasodilator,antiasthma,circulation improvement,symptomatic support,etc.The treatment group was additionally given non-invasive ventilator combined with pipeline atomization inhalation of Pulmicort on the basis of routine treatment.Both groups were treated continuously until the patient's symptoms were relieved.Clinical symptoms,N-terminal pro-brain natriuretic peptide(NT-proBNP),left ventricular ejection fraction(LVEF),left ventricular diastolic E peak/A peak(E/A) ratio,heart rate(HR),respiratory rate(RR),partial pressure of oxygen(PaO2),oxygen saturation(SatO2),oxygenation index(PaO2/FiO2),and time to symptom relief were compared.Results After treatment,the treatment effect of the treatment group was more obvious than that of the control group(P<0.05).Conclusion Non-invasive ventilator combined with pipeline atomization inhalation in treatment of acute left heart failure is more effective than conventional treatment,which can shorten the time of symptom relief,shorten the course of disease,improve the quality of life of patients,and have good tolerance.
Objective To explore the clinical efficacy of non-invasive ventilator combined with pipeline atomization inhalation in the treatment of acute left heart failure.Methods Eighty patients with acute left heart failure who were admitted to the Emergency Department of Kaiping Central Hospital from April 2016 to March 2018 were randomly divided into two groups,the control group and the treatment group,40 cases in each group.Both groups were given routine treatment,such as oxygen inhalation,cardiotonic,diuretic,vasodilator,antiasthma,circulation improvement,symptomatic support,etc.The treatment group was additionally given non-invasive ventilator combined with pipeline atomization inhalation of Pulmicort on the basis of routine treatment.Both groups were treated continuously until the patient's symptoms were relieved.Clinical symptoms,N-terminal pro-brain natriuretic peptide(NT-proBNP),left ventricular ejection fraction(LVEF),left ventricular diastolic E peak/A peak(E/A) ratio,heart rate(HR),respiratory rate(RR),partial pressure of oxygen(PaO2),oxygen saturation(SatO2),oxygenation index(PaO2/FiO2),and time to symptom relief were compared.Results After treatment,the treatment effect of the treatment group was more obvious than that of the control group(P<0.05).Conclusion Non-invasive ventilator combined with pipeline atomization inhalation in treatment of acute left heart failure is more effective than conventional treatment,which can shorten the time of symptom relief,shorten the course of disease,improve the quality of life of patients,and have good tolerance.
引文
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[2]张新超,于学忠.学习与运用欧美学术理论要同中国的临床实践相结合-谈“中国急性心力衰竭急诊临床实践指南(2017)”撰写[J].中国急救医学,2018,38(1):14-15.
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[5]张倩,齐维鹏,孙晓冬,等.无创呼吸机正压通气治疗急性左心衰竭的临床研究[J].心肺血管病杂志,2015,34(9):686-689.
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[10]中国医师协会急诊医师分会,中国心胸血管麻醉学会急救与复苏分会.中国急性心力衰竭急诊临床实践指南(2017)[J].中华急诊医学杂志,2017,26(12):1347-1357.
[11]冯春微,许少辉,廖静.无创呼吸机通气治疗急性左心衰23例的临床分析[J].现代预防医学,2011,38(16):3357-3359.
[12]程小兵.无创呼吸机在抢救急性左心衰中的临床分析[J].中华肺部疾病杂志,2011,4(5):405-407.
[13]中华医学会呼吸病学分会《雾化吸入疗法在呼吸疾病中的应用专家共识》制定专家组.雾化吸入疗法在呼吸疾病中的应用专家共识[J].中华医学杂志,2016,96(34):2696-2708.
[14]阮祥俭.普米克令舒雾化吸入治疗支气管哮喘急性发作期的疗效观察[J].吉林医学,2012,33(17):3668-3669.
[15]张良红,唐显俊.急性左心衰竭临床急性诊治分析[J].中国医学创新,2014,11(6):118-120.
[16]黄佐才,徐招柱,刘德忠,等.无创呼吸机辅助通气联合吗啡治疗急性左心衰竭的临床效果[J].中国医药科学,2016,6(9):207-209,225.
[17]张珏.无创呼吸机治疗34例急性左心衰的疗效研究[J].中国医药导报,2013,10(4):68-69,71.
[18]李晓燕.ICU无创正压通气治疗急性左心衰的临床观察[J].中外医学研究,2015,13(32):22-24.
[2]张新超,于学忠.学习与运用欧美学术理论要同中国的临床实践相结合-谈“中国急性心力衰竭急诊临床实践指南(2017)”撰写[J].中国急救医学,2018,38(1):14-15.
[3]临床诊疗指南.急诊医学分册/中华医学会编著[M].北京:人民卫生出版社,2009:199-200.
[4]周小曼.无创呼吸机治疗急性左心衰的效果分析[J].安徽医学,2013,34(3):307-308.
[5]张倩,齐维鹏,孙晓冬,等.无创呼吸机正压通气治疗急性左心衰竭的临床研究[J].心肺血管病杂志,2015,34(9):686-689.
[6]林杰,刘德昭,李春来,等.持续气道正压通气对急性左心衰患者血清NT-proBNP的影响及临床意义[J].临床医学工程,2012,19(6):891-893.
[7]杨成彬.有创机械通气及无创机械通气抢救急性重症左心衰竭的疗效[J].中国老年学杂志,2013,33(16):3863-3865.
[8]何书平.Bi PAP无创呼吸机治疗睡眠呼吸暂停综合征疗效观察[J].中国实用医药,2012,7(28):60-61.
[9]牛驰,郭伟,何小军,等.中国急诊科无创正压通气应用现状调查[J].中华急诊医学杂志,2018,27(2):204-207.
[10]中国医师协会急诊医师分会,中国心胸血管麻醉学会急救与复苏分会.中国急性心力衰竭急诊临床实践指南(2017)[J].中华急诊医学杂志,2017,26(12):1347-1357.
[11]冯春微,许少辉,廖静.无创呼吸机通气治疗急性左心衰23例的临床分析[J].现代预防医学,2011,38(16):3357-3359.
[12]程小兵.无创呼吸机在抢救急性左心衰中的临床分析[J].中华肺部疾病杂志,2011,4(5):405-407.
[13]中华医学会呼吸病学分会《雾化吸入疗法在呼吸疾病中的应用专家共识》制定专家组.雾化吸入疗法在呼吸疾病中的应用专家共识[J].中华医学杂志,2016,96(34):2696-2708.
[14]阮祥俭.普米克令舒雾化吸入治疗支气管哮喘急性发作期的疗效观察[J].吉林医学,2012,33(17):3668-3669.
[15]张良红,唐显俊.急性左心衰竭临床急性诊治分析[J].中国医学创新,2014,11(6):118-120.
[16]黄佐才,徐招柱,刘德忠,等.无创呼吸机辅助通气联合吗啡治疗急性左心衰竭的临床效果[J].中国医药科学,2016,6(9):207-209,225.
[17]张珏.无创呼吸机治疗34例急性左心衰的疗效研究[J].中国医药导报,2013,10(4):68-69,71.
[18]李晓燕.ICU无创正压通气治疗急性左心衰的临床观察[J].中外医学研究,2015,13(32):22-24.