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目的探讨双水平气道正压(BiPAP)无创通气治疗急性左心衰竭的临床疗效。方法对28例常规治疗无效的急性左心衰竭患者应用BiPAP无创通气治疗,记录治疗前后的呼吸功能及血气分析指标的变化,评价疗效,观察不良反应。结果有效26例(93%),均于治疗后0.5～1h呼吸困难缓解,湿啰音明显减少或消失胫瘟魄氨冉?治疗后患者的呼吸、心率、平均动脉压(MPA)均明显下降(P均<0.05),动脉血pH值、PaO2及脉搏血氧饱和度均明显升高(均为P<0.05);无效2例(7%)。治疗期间,出现腹胀2例(7%),未出现其他严重并发症。结论BiPAP无创通气可快速缓解呼吸困难,改善肺换气功能,纠正低氧血症,对急性左心衰竭的治疗效果良好。
Objective To investigate the clinical effect of bi-level positive airway pressure (BiPAP) non-invasive ventilation in the treatment of acute left heart failure. Methods BiPAP noninvasive ventilation was used in 28 patients with acute left heart failure who did not respond to conventional therapy. Changes in respiratory function and blood gas analysis indices were recorded before and after treatment, and the curative effect was evaluated. Adverse reactions were observed. The results were effective in 26 cases (93%). All of them were relieved of dyspnea at 0.5 ~ 1h after treatment, and their wet rales decreased or disappeared obviously. Respiratory rate, heart rate and mean arterial pressure (MPA) were significantly higher in patients with IHA (P <0.05). Arterial blood pH, PaO2 and pulse oximetry were significantly increased (all P <0.05), and 2 were ineffective (7%). During treatment, bloating occurred in 2 cases (7%) and no other serious complications occurred. Conclusion BiPAP non-invasive ventilation can quickly relieve dyspnea, improve pulmonary ventilation, correct hypoxemia, and have a good effect on acute left heart failure.