刘忠强 王丽娜

[摘要] 目的 分析無创呼吸机用于急诊急性心力衰竭合并呼吸衰竭的临床疗效。 方法 选取我院2018年6月～2019年6月在我院急诊治疗的急性心力衰竭合并呼吸衰竭患者62例，随机分为观察组和对照组，每组各31例。对照组患者予强心、利尿、平喘、纠正电解质紊乱等基础治疗，同时予低流量鼻导管吸氧治疗;观察组予无创呼吸机治疗。治疗后对比分析两组的临床疗效及血气分析指标的变化情况。 结果 观察组患者治疗后的总有效率达93.5%，高于对照组74.2%，差异有统计学意义（P<0.05）;两组患者的pH、PaO2及PaCO2水平分别比较，观察组改善情况均优于对照组（P<0.05）。 结论 无创呼吸机治疗急性心力衰竭合并呼吸衰竭疗效确切，且能有效改善动脉血气指标，促进患者呼吸功能迅速恢复，保护肺功能，从而改善患者的临床症状，且操作简便，值得推广和应用。

[关键词] 无创呼吸机;急诊;急性心力衰竭;合并;呼吸衰竭

[中图分类号] R541.6;R563.8          [文献标识码] B          [文章编号] 1673-9701（2020）18-0098-03

Clinical effect of non-invasive ventilator for emergency acute heart failure complicated with respiratory failure

LIU Zhongqiang1   WANG Li'na2

1.Department of Emergency， Beidaihe Hospital of Qinhuangdao City in Hebei Province， Qinhuangdao   066100， China; 2.Beidaihe Rehabilitation Care Centre， Combined Service Force of People's Liberation Army， Qinhuangdao   066100， China

[Abstract] Objective To observe and analyze the clinical effect of non-invasive ventilator used in emergency acute heart failure complicated with respiratory failure. Methods 62 patients with acute heart failure complicated with respiratory failure who were treated in the emergency department of our hospital from June 2018 to June 2019 were selected. They were randomly divided into two groups， with 31 cases in each group. One group was the control group， and the patients in the control group were given basic treatments such as cardiotonic， diuretic， antiasthmatic， and correction of electrolyte disturbance. At the same time， they were given low-flow nasal catheter oxygen therapy. One group was the observation group， and the patients in the observation group were treated with non-invasive ventilator. After treatment， the clinical efficacy and blood gas analysis indices were compared and analyzed in both groups. Results The total effective rate of patients in the observation group after treatment was 93.5%， which was significantly higher than that in the control group（74.2%） （P<0.05）. Compared with the control group， the pH， PaO2 and PaCO2 levels in the observation group were significantly improved（P<0.05）. Conclusion The non-invasive ventilator is effective in the treatment of acute heart failure complicated with respiratory failure， and it can effectively improve the arterial blood gas index， promote the rapid recovery of patient's respiratory function， and protect the lung function， thereby improving patients' clinical symptoms. It is also easy to operate， and is worthy of promotion and application.

[Key words] Non-invasive ventilator; Emergency; Acute heart failure; Complications; Respiratory failure

急性心力衰竭合并呼吸衰竭是急诊科的急危病症之一，需立即采取抢救措施，若治疗不及时，常导致患者出现生理功能和代谢紊乱，甚至危及患者的生命[1]。以往急性心力衰竭合并呼吸衰竭常使用有创机械通气，并发症多，患者依从性差，且无法帮助患者彻底改善自身疾病[2]。随着医疗技术的不断进步和设备的不断发展，无创呼吸机由于无创、并发症少、效果好等优点[3]，逐渐应用于急性心力衰竭或呼吸衰竭患者的治疗中，并取得了较好的临床效果。本研究旨在观察无创呼吸机用于急诊急性心力衰竭合并呼吸衰竭患者的临床疗效，现报道如下。

1 资料与方法

1.1 一般资料

选取2018年6月～2019年6月在我院急诊治疗的急性心力衰竭合并呼吸衰竭患者62例。纳入标准：患者临床资料完整，患者及家属均对本研究知情同意，无机械通气禁忌证，NYHA心力衰竭分级Ⅳ级;排除标准：合并严重心、肝、肾等脏器功能不全，患有精神疾病、免疫系统疾病及恶性肿瘤。……