急性左心功能衰竭并Ⅱ型呼吸衰竭应用早期与延迟无创通气治疗临床分析.docVIP

急性左心功能衰竭并Ⅱ型呼吸衰竭应用早期与延迟无创通气治疗临床分析 　　[摘要] 目的 对无创通气早期治疗和延迟治疗急性左心衰竭合并Ⅱ型呼吸衰竭患者的临床效果开展对比研究，以期判定应用的最佳时机。方法 便利选取该院2013年5月―2016年10月收治的92例急性左心衰合并II型呼吸衰竭患者，根据无创呼吸机治疗时间，将其分为观察组46例和对照组46例。记录比较2组患者经治疗3 h后临床症状，检测呼吸频率（RR）、平均动脉压（MBP）、心率（HR）及氧分压（PaO2），比较治疗后显效和总有效率。 结果 治疗后，观察组HR、MBP、RR、PaO2分别为（93.33±21.47）次/min、（89.65±17.78）mmHg、（23.55±4.19）次/min、（93.80±19.24）mmHg，均显著优于对照组，差异有统计学意义（P0.05）。观察组显效率、总有效率分别为76.09%、95.65%，均高于对照组（P0.05）。结论 给予急性左心衰竭合并Ⅱ型呼吸衰竭患者早期无创正压通气治疗可显著改善左心功能、肺通气，提高治疗总有效率，值得进一步推广。 　　[关键词] 急性左心功能衰竭；Ⅱ型呼吸衰竭；无创通气；治疗结果 　　[中图分类号] R541 [文献标识码] A [文章编号] 1674-0742（2017）05（b）-0074-03 　　[Abstract] Objective To compare and research the clinical effect of early and delayed noninvasive ventilation for acute left heart failure and type Ⅱ respiration failure in order to determine the best application opportunity. Methods 92 cases of patients with acute left heart failure and type Ⅱ respiration failure admitted and treated in our hospital from May 2013 to October 2016 were randomly selected and divided into two groups with 46 cases in each according to the noninvasive ventilation treatment time， the clinical symptoms， RR， MBP， HR and PaO2 at 3 h after treatment were compared between the two groups， and the markedly effective rate and total effective rate after treatment were compared after treatment. Results After treatment， the HR，MBP，RR，PaO2 in the observation group were respectively（93.33±21.47）times/min，（89.65±17.78）mmHg， （23.55±4.19）times/min，（93.80±19.24）mmHg， which were obviously better than those in the control group， and the differences were statistically significant（P0.05）， and the markedly effective and total effective rate in the observation group were respectively 76.09% and 95.65%， which were higher than those in the control group（P0.05）. Conclusion The early noninvasive ventilation for acute left heart failure and type Ⅱ respiration failure can obviously improve the left heart function and lung ventilation and improve the total treatment effective rate， which is worth fu