无创呼吸机治疗慢性阻塞性肺疾病合并左心衰竭疗效观察.docVIP

无创呼吸机治疗慢性阻塞性肺疾病合并左心衰竭疗效观察 　　[摘要] 目的 观察采用无创呼吸机辅助通气治疗AECOPD合并左心衰竭的临床疗效。 方法 将本院2010年9月～2012年12月收治的116例AECOPD合并左心衰竭患者随机分为两组，对照组54例给予常规药物治疗，治疗组62例在常规药物治疗基础上采用无创呼吸机辅助通气治疗。观察两组患者治疗后2 h、24 h、7 d的呼吸频率（RR）、心率（HR）、收缩压（SBP）、指脉氧（SPO2）、血气分析、BNP变化，分析比较两种方法的疗效。 结果 两组经2 h、24 h、7 d，治疗后，PaO2、pH值较治疗前均有明显升高，PaCO2则较治疗前均降低（P0.05），但治疗7 d后治疗组BNP下降较对照组明显，差异有统计学意义（P0.05）。 结论 无创呼吸机辅助通气治疗可有效改善AECOPD合并左心衰竭患者的缺氧状态，缓解呼吸机疲劳，提高抢救成功率。 　　[关键词]无创呼吸机；慢性阻塞性肺疾病；左心衰竭 　　[中图分类号] R563 [文献标识码] B [文章编号] 2095-0616（2013）15-35-03 　　Efficacy observation of non-invasive ventilation treatment of chronic obstructive pulmonary disease complicated by left heart failure 　　ZHANG Chen 　　Department of Internal Medicine，Zhengzhou Traffic Hospital，Zhengzhou 450001，China 　　[Abstract] Objective To observe the clinical efficacy of the non-invasive ventilation treatment of the acute exacerbation chronic obstructive pulmonary disease （AECOPD） complicated by left heart failure. Methods 116 patients with AECOPD complicated by left heart failure who were treated in our hospital from September 2010 to December 2012 were randomly divided into two groups.The 54 patients of the control group were given conventional drug treatment and the 62 patients of the treatment group were given non-invasive ventilation treatment on the basis of the conventional treatment.The respiratory rate （RR），heart rate （HR），systolic blood pressure （SBP），saturation pulse oxygen （SPO2），blood gas analysis and BNP changes 2 hours，24 hours and 7 days after the treatment of the two groups were observed. Results After 2 hours，24 hours and 7 days of treatment，the PaO2 and pH values of both groups elevated significantly compared to those before the treatment while the PaCO2 values of both groups decreased compared to those before the treatment （P0.05）.After 2 hours and 24 hours of treatment，the treatment group and the control group had similar BNP improvement situation，with no statistically significant difference （P0.05），but after 7 days of treatment，the BNP of