摘要
目的探讨有创呼吸机正压通气治疗急性重度心肌梗死并左心衰竭的临床效果。方法选择2011年5月—2014年5月四川省内江市第一人民医院重症医学科收治的急性重度心肌梗死并左心衰竭80例,采用随机数字表法分为观察组和对照组,每组40例。两组均给予常规治疗,对照组给予无创呼吸机正压通气治疗,观察组应用气管插管呼吸机正压通气治疗,比较两组治疗前后相关指标及病死率、住院时间。结果治疗后1 d与治疗前比较,两组心率和二氧化碳分压(Pa CO2)均下降,氧分压(Pa O2)和p H均升高(P<0.05);观察组超敏肌钙蛋白较对照组降低(P<0.05)。治疗后3 d,两组心搏出量、射血分数均较治疗前升高,超敏肌钙蛋白较治疗前下降,且观察组较对照组改变更明显(P<0.05)。观察组病死率低于对照组,住院时间短于对照组(P<0.05)。结论有创正压通气治疗急性重度心肌梗死并左心衰竭,能明显改善患者心肌缺氧、心功能、肺通气及换气功能,提高治疗效果。
Objective To investigate the clinical value of invasive positive pressure ventilation with breathing machine in treatment of patients with serious acute myocardial infarction and left ventricular failure. Methods A total of80 patients with serious acute myocardial infarction and left ventricular failure during May 2011 and May 2014 were divided into observation group（ n = 40） and control group（ n = 40） according to random digits table method. All patients received conventional therapy,the control group was treated with noninvasive positive pressure ventilation（ NPPV） treatment,while the observation group was treated with invasive positive pressure ventilation treatment using tracheal intubation. The values of related indexes,the fatality rate and length of hospital stay in the two groups were compared. Results On the 1std after the treatment,the values of heart rate（ HR） and Pa CO2（arterial carbon dioxide tension） were decreased,while the values of Pa O2（arterial oxygen tension） and PH were increased in the two groups compared with those before the treatment; supersensitive troponin（ Tn） level in the observation group was decreased compared with that in the control group（ P〈0. 05）. The values of stroke volume（ SV） and ejection fraction（ EF） were increased,while the values of supersensitive Tn were decreased in the two groups on 3rdd after the treatment compared with those before the treatment,and the changes in the observation group was more obvious compared with those in the control group（ P〈0. 05）.The fatality rate was significantly lower,and length of hospital stay was significantly shorter in the observation group compared with those in the control group（ P〈0. 05）. Conclusion The invasive positive pressure ventilation in treatment of patients with serious acute myocardial infarction and left ventricular failure may significantly improve myocardial anoxia,cardiac function,lung ventilation and ventilation function with better therapeutic effect.
出处
《解放军医药杂志》
CAS
2015年第5期97-99,共3页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
关键词
心肌梗死
心力衰竭
有创呼吸机正压通气
气管插管
Myocardial infarction
Heart failure
Invasive positive pressure ventilation
Tracheal intubation
