序贯性通气对重症急性左心衰竭合并呼吸衰竭的实效性评价

摘要

目的：探讨序贯性通气治疗重症急性左心衰竭(ALHF)合并呼吸衰竭的临床疗效。方法选择2013年6~12月入住四川省金堂县第一人民医院ICU中心的ALHF合并呼吸衰竭患者96例，随机分为观察组和对照组，每组各48例。在常规治疗基础上观察组进行序贯性通气疗法，对照组采用普通机械通气疗法。观察两组患者的总治愈率、治疗后血氧分压(PaO2)值、氧饱和度(SaO2)值、通气时间以及死亡率。结果观察组患者治疗有效47例，有效率为97.9%，而对照组有效40例，有效率为83.3%，差异具有统计学意义(P<0.05)；观察组机械通气时间、有创通气时间和死亡者分别为(7.5±3.1) d、(4.2±2.7) d和3例；对照组则分别为(9.8±4.5) d、(8.1±4.7) d和10例，差异均具有统计学意义(P<0.05)；治疗后，观察组PaO2值和SaO2值分别为(92.7±6.8) mmHg和(95.6±4.8) mmHg，对照组为(78.5±7.9) mmHg和(89.5±4.9) mmHg，差异均具有统计学意义(P<0.01)。结论 ICU中心对ALHF患者实施序贯性通气具有较好的临床疗效，对患者的康复具有重要价值。%Objective To explore the effects of sequential ventilation for treating acute left heart failure (AL-HF) complicated with respiratory failure. Methods Ninety-six ALHF patients complicated with respiratory failure in ICU of the First People's Hospital of Jintang City from August 2012 to January 2014 were selected. The patients were randomly divided into observation group and control group, with 48 patients in each group. The observation group ac-cepted sequential ventilation on the basis of conventional therapy, while the control group received conventional ventila-tion for treatment. The total cure rate, PaO2 and SaO2 value, ventilation time and mortality were observed. Results The treatment was found effective in 47 cases in the observation group and 40 cases in the control group, and the total ef-fective rate was 97.9%and 83.3%, respectively, with statistically significant differences between the two groups (P<0.05). The time of mechanical ventilation, invasive ventilation time and mortality were (7.5±3.1) d, (4.2±2.7) d, 3 pa-tients in observation group, and (9.8±4.5) d, (8.1±4.7) d, 3 patients in control group, with statistically significant differ-ences between the two groups (P<0.05). After treatment, PaO2 and SaO2 were (92.7 ± 6.8) mmHg and (95.6 ± 4.8) mmHg in the observation group, (78.5±7.9) mmHg and (89.5±4.9) mmHg in the control group, with statistically signif-icant differences between the two groups (P<0.01). Conclusion Sequential ventilation has better clinical curative ef-fect for ALHF patients complicated with respiratory failure, compared with conventional therapy, which has important value for the rehabilitation of the patients.