韩磊磊

[摘要] 目的 观察有创及无创机械通气抢救急性重症左心衰竭患者的临床应用效果。 方法 选择本院收治125例急性重症左心衰竭患者为研究对象，随机分为有创机械通气组（68例）和无创机械通气组（57例），观察并比较两组患者的抢救效果。 结果 有创机械通气组患者的生命体征和血气分析指标改善情况明显优于无创机械通气组，差异有统计学意义（P<0.01）；治疗后两组患者血清脑钠肽水平较治疗前均明显降低，差异有统计学意义（P<0.01）；治疗后有创机械通气组血清脑钠肽水平较无创机械通气组显著降低，差异有统计学意义（P<0.01）。 结论 机械通气治疗急性左心衰竭，能够有效改善患者的低氧血症，缓解患者的临床症状，是抢救急性重症左心衰竭患者安全有效的措施，且有创机械通气比无创机械通气的治疗效果更佳。

[关键词] 左心衰竭；机械通气；抢救效果

[中图分类号] R541.6[文献标识码] B[文章编号] 1674-4721（2014）06（a）-0188-03

Comparison of effectiveness between invasive and non-invasive mechanical ventilation in treating severe acute left heart failure

HAN Lei-lei

Department of Emergency Internal,Huaxin Hospital & the First Hospital of Tsinghua University,Beijing 100016,China

[Abstract] Objective To evaluate the effectiveness of invasive and non-invasive mechanical ventilation in treating severe acute left heart failure. Methods 125 cases with severe acute left heart failure were randomly divided into invasive mechanical ventilation group (68 cases) and non-invasive mechanical ventilation group (57 cases).The effectiveness between the two groups was compared. Results The improvement of vital signs and blood gas analysis indexes in invasive mechanical ventilation group was significantly better than the non-invasive mechanical ventilation group (P<0.01).After treatment,serum brain natriuretic peptide levels in both groups were significantly lower than before treatment,the difference was statistically significant (P<0.01).After treatment,serum brain natriuretic peptide levels in invasive mechanical ventilation group was lower than noninvasive mechanical ventilation group,showing significant statistically difference (P<0.01). Conclusion Mechanical ventilation is a safe and effective therapy for the treatment of patients with severe acute left heart failure,which can improve hypoxemia and relieve symptoms of patients,and invasive mechanical ventilation treatment shows more effective than non-invasive mechanical ventilation treatment.

[Key words] Left heart failure;Mechanical ventilation;Effectiveness

急性重症左心衰竭是临床上一种严重的疾病，该病其起病急、进展较快，患者病情常较严重，如抢救不及时，致死率很高。急性重症左心衰竭患者常因急性肺水肿而导致严重的低氧血症，并可造成患者全身脏器缺氧性代谢损害，严重威胁患者的生命安全[1]。目前，临床上常规治疗重症急性左心衰竭的方法，如氧疗和注射强心剂、利尿剂等，因患者个体差异较大而效果不理想。自有创机械通气应用于治疗急性重症左心衰竭患者以来，其已成为临床上一种重要的治疗急性重症左心衰竭的方法，无创机械通气用于治疗急性重症左心衰竭具有无创、操作方便等优点，在急性左心衰竭的治疗中占重要地位。目前，关于无创通气和有创通气的临床疗效比较的报道较少，本研究通过对比分析这两种通气方法用于临床抢救的疗效，以便进一步提高该类疾病的临床治疗水平。

1 资料与方法

1.1 一般资料

选择本院2010年4月～2013年……