早期气管插管行机械通气在急性重症左心衰竭抢救中的价值

摘要

目的 评价早期气管插管行机械通气在急性重症左心衰竭抢救中的价值.方法 根据是否早期应用气管插管行机械通气将112例急性重症左心衰竭患者分为早期机械通气组(36例)和常规机械通气组(76例),比较2组患者血脑钠尿肽值、症状缓解对间、机械通气时间、住院时间及痛死率.结果 与常规机械通气组比较,早期机械通气组症状缓解时间快[(4.3±1.1 )h vs(7.3±2.1)b,P＜0.01)],机械通气时间短[(66.4±12.4)h vs (78.3±15.6)h,P＜0.01)],入院7d血脑钠尿肽浓度低[(452±112) ng/Lvs (634±232)ng/L,P＜0.01)],住院时间短[(15.3±5.1)d vs (21.1±7.1)d,P＜0.01)],住院期间病死率低(8.3％ vs 27.6％,P＜0.05).结论 早期气管插管行机械通气治疗,能较快缓解急性重疰左心衰竭患者的临床症状,减少机械通气时间,缩短住院时间,减少住院期间病死率.%Objective To evaluate the effectiveness of early trachea cannula mechanical ventilation in treating severe acute left ventricular failures. Methods One hundred and twelve patients with severe acute left ventricular failures were divided into two groups;early mechanical ventilation group (n=36)and conventional mechanical ventilation group (n=76). The time of symptomatic relief, duration of mechanical ventilation, blood-brain natriuretic peptide(BNP) ,inpatient time and hospital mortality of the two groups were compared. Results Compared with conventional mechanical ventilation group,early mechanical ventilation group's time of symptomatic relief decreased significantly [ <4.3±1. 1 )h vs(7.3±2.1 )h,P<0.01 ] ;its duration of mechanical ventilation [(66.4±12.4 )h us (78.3 ±15.6)h,P<0.01]and BNP concentration [(452 ±112)ng/L vs (634 ±232)ng/L,P<0.01]also decreased. 7 days after hospitalization,parly mechanical ventilation group's inpatient lime[ (15.3±5.1 )d vs (21.1±7.1 )d,P<0.01]and hospital mortality (8.3% vs 27.6%,P<0.05)bolh decreased. Conclusions Early trachea cannula mechanical ventilation can decrease the time of symptomatic relief,duration of mechanical ventilation,inpatient time and hospital mortality of the patients with severe acute left ventricular failure.