无创机械通气治疗慢性阻塞性肺疾病急性加重期合并急性心力衰竭患者的临床观察

王晓飞

(天津中医药大学附属武清中医院重症医学科，天津　301700)

无创机械通气治疗慢性阻塞性肺疾病急性加重期合并急性心力衰竭患者的临床观察

王晓飞

(天津中医药大学附属武清中医院重症医学科，天津301700)

[摘要]目的：观察无创机械通气治疗慢性阻塞性肺疾病急性加重期(AECOPD)合并急性心力衰竭患者的临床疗效。方法：选取100例符合条件的AECOPD合并有急性心力衰竭患者，随机分成对照组和治疗组，对照组予以常规疗法，治疗组在常规治疗基础上加用无创机械通气，比较两组患者的血气结果及心功能改善程度。结果：治疗组患者每搏量(SV)、每分钟心排血量(CO)、心指数(CI)、BNP、动脉血氧分压(PaO2)、pH值水平都较对照组患者有显著改善;治疗组患者的二氧化碳分压(PaCO2)水平显著的低于对照组患者，差异有统计学意义(P﹤0.05)。结论：无创机械通气治疗AECOPD合并急性心衰疗效好于常规疗法。

[关键词]无创机械通气；慢性阻塞性肺疾病急性加重期；急性心力衰竭

Abstract：ObjectiveTo observe clinical curative effect of the treatment in which noninvasive mechanical ventilation was used in patients with acute exacerbation of chronic obstructive pulmonary disease combined with acute heart failure.Method100 patients with eligible AECOPD complicated with acute heart failure were selected,who were randomly divided into treatment group and control group,the control group was given routine therapy,the treatment group was given noninvasive mechanical ventilation on the basis of routine treatment,to compare the blood gas analysis results and improvement of heart function between the two groups.ResultsCompared with control group,the results of SV、CO、CI、BNP、PaO2、pH in treatment group were significant improved;and the level of PaCO2was lower.The difference was statistically significant(P<0.05).ConclusionNoninvasive mechanical ventilation is used in patients with acute exacerbation of chronic obstructive pulmonary disease Combined with acute heart failure,which is better than routine therapy.

[收稿日期：2014-12-15编校：王丽娜]

Clinical observation of noninvasive mechanical ventilation in the treatment of patient with acute exacerbation of chronic obstructive pulmonary disease with acute heart failureWANGXiao-fei(Intensivemedicine，WuqingHospitaloftraditionalChineseMedicine,Tianjin301700,China)

Key Words:Noninvasive mechanical ventilation；Acute exacerbation of chronic obstructive pulmonary disease；Acute heart failure

慢性阻塞性肺疾病(COPD)是老年人常见的一种呼吸系统疾病，以不完全可逆性气流受限为特征，病程普遍较长[1]，在COPD的发展过程中，患者常因感染及其他因素诱发COPD急性加重(AECOPD)，而且很多COPD患者由于病程迁延，机体长期缺氧使肺血管收缩、痉挛、肺动脉压力过高，导致心功能不全，因此很多AECOPD患者常常合并有急性心力衰竭[2]，严重影响患者生活质量，病死率高，对于临床救治提出了很高的要求。我科采用无创机械通气治疗AECOPD合并急性心衰患者，通过分析患者治疗前后血气分析、心功能等数据，探析无创机械通气在AECOPD合并急性心力衰竭患者治疗中的价值。……