国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2009年
15期
67-70
,共4页
急性左心衰%机械通气%持续正压通气%呼气末正压%同步间歇指令通气
急性左心衰%機械通氣%持續正壓通氣%呼氣末正壓%同步間歇指令通氣
급성좌심쇠%궤계통기%지속정압통기%호기말정압%동보간헐지령통기
Acute left heart failure%Mechanical ventilation%Continued positive air-pressure posi-tive end-expiratory pressure%Synchronized intermittent mandatory ventilation
目的 探讨不同机械通气模式在抢救急性左心衰竭病人的临床疗效.方法 将87例急性左心衰竭伴意识障碍病人分为三组,对照组应用常规治疗,治疗组Ⅰ常规治疗基础上加用气管插管接呼吸机CPAP(持续正压通气continued positive air-pressure),治疗组Ⅱ常规治疗基础上加用气管插管接呼吸机SIMV+PEEP模式通气.观察各组治疗2小时后心率、血压、动脉血气分析等指标和临床表现的变化.结果 与对照组比较,其它两组pH值、PaO2、PaO2/FiO2均明显改善(P<0.05),而心率、血压和PaCO2却无明显变化(均P>0.05).治疗组Ⅱ对PaO2/FiO2的改善较治疗组Ⅰ显著(P<0.05),Ⅰ组和Ⅱ组临床表现有效率分别为86.2%和96.5%(P<0.05).结论 根据病情选择合适的正压机械通气方式抢救急性左心衰疗效显著,值得推广.
目的 探討不同機械通氣模式在搶救急性左心衰竭病人的臨床療效.方法 將87例急性左心衰竭伴意識障礙病人分為三組,對照組應用常規治療,治療組Ⅰ常規治療基礎上加用氣管插管接呼吸機CPAP(持續正壓通氣continued positive air-pressure),治療組Ⅱ常規治療基礎上加用氣管插管接呼吸機SIMV+PEEP模式通氣.觀察各組治療2小時後心率、血壓、動脈血氣分析等指標和臨床錶現的變化.結果 與對照組比較,其它兩組pH值、PaO2、PaO2/FiO2均明顯改善(P<0.05),而心率、血壓和PaCO2卻無明顯變化(均P>0.05).治療組Ⅱ對PaO2/FiO2的改善較治療組Ⅰ顯著(P<0.05),Ⅰ組和Ⅱ組臨床錶現有效率分彆為86.2%和96.5%(P<0.05).結論 根據病情選擇閤適的正壓機械通氣方式搶救急性左心衰療效顯著,值得推廣.
목적 탐토불동궤계통기모식재창구급성좌심쇠갈병인적림상료효.방법 장87례급성좌심쇠갈반의식장애병인분위삼조,대조조응용상규치료,치료조Ⅰ상규치료기출상가용기관삽관접호흡궤CPAP(지속정압통기continued positive air-pressure),치료조Ⅱ상규치료기출상가용기관삽관접호흡궤SIMV+PEEP모식통기.관찰각조치료2소시후심솔、혈압、동맥혈기분석등지표화림상표현적변화.결과 여대조조비교,기타량조pH치、PaO2、PaO2/FiO2균명현개선(P<0.05),이심솔、혈압화PaCO2각무명현변화(균P>0.05).치료조Ⅱ대PaO2/FiO2적개선교치료조Ⅰ현저(P<0.05),Ⅰ조화Ⅱ조림상표현유효솔분별위86.2%화96.5%(P<0.05).결론 근거병정선택합괄적정압궤계통기방식창구급성좌심쇠료효현저,치득추엄.
Objective Investigate the clinic curative effect of Vary Mechanical ventilation pattern in the saving of acute left heart failure (ALHF).Methods 87 ALHF patients with conscious disorder were divided into three groups. Control group was treated by conventional therapy. In addition to conventional therapy, treatment group Ⅰ were applied CPAP and treatment group Ⅱ were applied SIMV+PEEP. Evaluating the changes of clinical symptoms, heart rate(HR), blood pressure, pH, PaO2 and PaO2/FiO2 after 2 hours among the groups. Results After 2 hours, the pH, PaO2 and PaO2/FiO2 ratio were significantly increased in the two groups compared with control group (P<0.05). There were no change in the heart rate, blood pressure and PaCO2.The PaO2/FiO2 ratio was significantly higher in the group Ⅱ than that in the group Ⅰ (P<0.05), and the improvement rate was also significantly higher in the group Ⅱ than that in the group Ⅰ (96.5% vs 86.2%, P<0.05). Conclusions According to the condition of patient, chosing suitable mechanical ventilation is shows remarkable effect in the saving of ALHF with conscious disorder, such approach is worth spreading.
