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目的:探究早期与延迟无创呼吸机辅助治疗急性左心衰竭并发Ⅱ型呼吸衰竭的临床疗效。方法:选择2012年8月到2015年8月期间,我院收治临床确诊急性左心衰竭并发Ⅱ型呼吸衰竭患者68例为研究对象,将随着随机分为观察组(35例)和对照组(33例);观察组患者行早期无创呼吸机辅助治疗,对照组给予延迟无创呼吸机辅助治疗;观察并比较两组间治疗前后呼吸频率(RR)、心率(HR)、动脉氧分压(PaO_2)及平均动脉压(MAP)、气管插管及气管切开通气率、住院时间及治疗有效率的情况。结果:疗后两组患者RR、HR、MAP均下降,MBP升高(P<0.05),且观察组患者RR、HR及MAP均低于对照组,PaO_2均高于对照组,差异均有统计学意义(P<0.05);治疗后观察组患者有效率显著高于对照组,气管切开及插管发生率、病情好转时间、住院时间均低于对照组(P<0.05)。结论:急性左心衰竭并发Ⅱ型呼吸衰竭患者早期行无创呼吸机辅助治疗能显著改善患者症状、提高治疗有效率,缩短患者住院时间,具有较高的临床价值。
Objective: To investigate the clinical efficacy of early and delayed noninvasive ventilator-assisted therapy for acute left heart failure complicated with type Ⅱ respiratory failure. Methods: From August 2012 to August 2015, 68 patients with clinically diagnosed acute left ventricular failure and type Ⅱ respiratory failure in our hospital were selected as study subjects and randomly divided into observation group (35 cases) and control group (N = 33). The patients in the observation group underwent early noninvasive ventilator assisted therapy and the control group received delayed noninvasive ventilator assisted therapy. The changes of respiratory rate (RR), heart rate (HR), arterial oxygen tension PaO_2) and mean arterial pressure (MAP), endotracheal intubation and tracheostomy ventilation rate, hospital stay and treatment efficiency. Results: After treatment, the RR, HR, MAP decreased and MBP increased (P <0.05), and RR, HR and MAP in the observation group were lower than those in the control group, PaO_2 were higher than the control group, the difference was statistically (P <0.05). After treatment, the effective rate of the observation group was significantly higher than that of the control group. The incidence of tracheotomy and intubation, the time of improvement and the length of hospital stay were all lower than those of the control group (P <0.05). Conclusions: Early noninvasive ventilator assisted therapy in patients with acute left heart failure complicated with type Ⅱ respiratory failure can significantly improve the symptoms, improve the treatment efficiency and shorten the hospitalization time of patients with high clinical value.