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目的观察机械通气在对抢救重度急性左心衰中的疗效。方法选择急诊入院的32例重度急性左心衰患者,在常规治疗的同时采用有创正压机械通气,观察通气前后2h及24h生命体征及血气指标变化。结果通气治疗后,32例患者中26例(81.3%)病情好转,均于30min～2h内紫绀消失,心悸、气促、呼吸困难症状明显改善,肺部啰音明显减少(减少到1/2肺野以下)或消失,意识模糊者神志转清,24h后病情趋向稳定。4例(12.5%)死亡,其中3例死于大面积心梗合并心源性休克,1例死于心脏骤停,1例感染性心内膜炎合并二尖瓣脱垂症状好转后因经济困难放弃治疗,出院后第2天死亡。患者生命体征及血气指标在机械通气前后2h及24h比较差异有统计学意义(P<0.05)。结论有创机械通气是抢救重度急性左心衰的一种有效措施。
Objective To observe the effect of mechanical ventilation on rescuing severe acute left heart failure. Methods Thirty-two patients with severe acute left heart failure admitted to our hospital were enrolled in this study. Venous invasive mechanical ventilation was used to observe the changes of vital signs and blood gas indexes at 2 hours and 24 hours before and after ventilation. Results After ventilation, 26 cases (81.3%) of 32 patients got better. The cyanosis disappeared within 30min ~ 2h. Heart palpitations, shortness of breath and dyspnea were significantly improved. The pulmonary rales were significantly reduced Lung field or below) or disappear, confusion conscious mind clear, 24h after the disease tends to be stable. Four (12.5%) died, of which three died of massive myocardial infarction with cardiogenic shock, one died of a cardiac arrest, and one had endocarditis with mitral valve prolapsed Difficult to give up treatment, died on the second day after discharge. The patients’ vital signs and blood gas indexes were significantly different at 2h and 24h before and after mechanical ventilation (P <0.05). Conclusion Invasive mechanical ventilation is an effective measure to rescue severe acute left heart failure.