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无创性机械通气治疗慢性顽固性心力衰竭的回顾性分析 被引量:1

A Retrospective Study on the Treatment of Patients with Severe Chronic Heat Failure via Face Mask Mechanical Ventilation
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摘要 目的:研究经面罩机械通气(FMMV)对慢性顽固性心力衰竭(CHF)患者心肺功能的作用。方法:回顾性分析12例药物治疗效 果不佳 CHF 的患者 FMMV 后的临床表现、胸部 X 线片和动脉血气的变化。结果:FMMV 后,12例患者在30 min 内皆能较好耐受 FMMV,呼吸困难减轻;2 h 后症状明显改善,RR 从(35±7) 次/min 降至(22±4) 次/min(P<0. 05) ,HR 从(129±15) 次/12min 降至(108 ±10) 次/min(0. 05) ;24 h 后继续改善;3~5 d 基本缓解,自然呼吸时的 RR(16±3) 次/min(P<0 05) ,HR(87±9) 次/min(P<0. 05) 。 在吸氧流量相同的情况下,2 h 后 PaO_2从(74±8) mmHg 升至(96±22) mmHg(P<0. 05) ,24 h 后至(114±18) mmHg(P<0. 05) 。 脱机后吸空气时,PaO_2为(79±6) mmHg。无明显副作用。结论:FMMV 可较快改善顽固性 CHF 患者的呼吸和循环功能。 Objective:To assess the value of treatment of chronic heat failure(CHF) via face mask mechanical ventilation(FMMV). Methods: That the symptoms and signs, the X rays appearance of chest,and artery blood gases of 12 CHF patients which failed to drug treatment were analyzed retrospectively. Results: 12 patients had good compliance, dyspnoea was improved after 30 mintes via FMMV. Respiratory rates decreased from (35± 7)times/rain to (22 ±4)times/min (P〈0. 05),heart rates decreased from (129± 15)times/min to (108± 10) times/rain (P〈0. 05) after 2 hours. The artery blood gases showed that PaO2 rose from (74± 8)mmHg to (96 ± 22)mmHg after 2 hours(P〈0. 05) ,and to (114± 18)mmHg after 24 hours (P〈0. 05). 12 patients were weaned from ventilator in 3-5 days. At the end PaO2 was (79 ± 6)mmHg (P〈0.05) during freely breathing ai. Conclusion: FMMV can improve cardiac function and pulmonary function of severe CHF patients who failed to drug treatment.
出处 《中国临床医学》 北大核心 2005年第5期771-772,共2页 Chinese Journal of Clinical Medicine
关键词 慢性心力衰竭 机械通气 气体交换 心功能 Chronic heat failure Mechanical ventilation Gas exchange Cardiac function
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参考文献4

  • 1Tobin MJ. Principles and practice of mechanical ventilation[M]. New York : McGraw- Hill, Inc, 1994,339-647.
  • 2Bersten AD, Holt AW, Vedig AE,et al. Treatment of severe cardiogenic pulmonary edema with continuous positive airway pressure dliverd by face mask[J]. N Engl J Med,1991,325:1825-1830.
  • 3叶任高.内科学[M](第5版)[M].北京:人民卫生出版社,2001.824.
  • 4Evans TW, Albert RK, Angus DC,et al. International consensus conferences in intensive care medicine: noninvasive positive pressure ventilation in acute respiratory failure[J]. Am J Respir Crit Care Med. 2001,163:283-291.

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