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目的总结探讨无创机械通气治疗老年严重急性心力衰竭的疗效及临床价值。方法52例于2006年6月-2008年1月住院治疗的老年重症急性心衰合并呼吸衰竭患者,随机分为常规治疗组(药物治疗及氧疗)和无创通气组。无创通气组在常规治疗基础上加用机械通气治疗。观察两组患者在治疗前后心率(HR)、呼吸频率(RR)、平均动脉压(MAP)、血气分析(pH、PaO2、PaCO2、SaO2)及临床症状改善情况。结果机械通气治疗后,患者呼吸困难明显改善,生命体征很快稳定,血气分析指标治疗明显好转。治疗组有效率明显高于对照组,病死率明显低于对照组(P<0.05),好转时间明显少于对照组(P<0.05),机械通气前后血气改善明显(P<0.05)。结论对急性心力衰竭,机械通气能及时有效地改善患者的临床症状及低氧血症,是抢救急性心力衰竭合并呼吸衰竭的有效辅助措施。
Objective To summarize the efficacy and clinical value of noninvasive mechanical ventilation in the treatment of elderly patients with severe acute heart failure. Methods 52 elderly patients with severe acute heart failure and respiratory failure who were hospitalized from June 2006 to January 2008 were randomly divided into conventional treatment group (drug treatment and oxygen therapy) and non-invasive ventilation group. Non-invasive ventilation group in the conventional treatment plus mechanical ventilation. The heart rate (HR), respiratory rate (RR), mean arterial pressure (MAP), blood gas analysis (pH, PaO2, PaCO2, SaO2) and clinical symptoms of the two groups were observed before and after treatment. Results After mechanical ventilation, dyspnea was significantly improved in patients with vital signs quickly stabilized, blood gas analysis indicators improved significantly. The treatment group was significantly higher than the control group, the mortality was significantly lower than the control group (P <0.05), the improvement time was significantly less than the control group (P <0.05), before and after mechanical ventilation improved significantly (P <0.05). Conclusion For acute heart failure, mechanical ventilation can effectively improve the clinical symptoms and hypoxemia in patients. It is an effective adjuvant to rescue acute heart failure complicated with respiratory failure.