| 李雯莉,董江宏,殷富康,高冉冉,彭 鹏.双水平气道内正压通气治疗尿毒症合并左心衰竭患者的疗效观察[J].,2017,17(14):2700-2702 |
| 双水平气道内正压通气治疗尿毒症合并左心衰竭患者的疗效观察 |
| Efficacy of Bi Level Positive Airway Pressure Ventilation in the Treatment of Uremic Patients with Left Heart Failure |
| 投稿时间：2016-08-26 修订日期：2016-09-20 |
| DOI：10.13241/j.cnki.pmb.2017.14.024 |
| 中文关键词: 双水平气道内正压通气 尿毒症 左心衰竭 |
| 英文关键词: Bi level positive airway pressure ventilation Uremia Left heart failure |
| 基金项目:乌鲁木齐高新区科技计划项目（KJJH2014010） |
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| 中文摘要: |
| 摘要 目的：观察双水平气道内正压通气（BiPAP）治疗尿毒症合并左心衰竭患者的临床疗效。方法：选取82例确诊为尿毒症合并左心衰竭的患者，在患者进行常规的强心、利尿、扩血管、持续性肾替代治疗（CRRT）30 min后无缓解后，立即对患者进行BiPAP治疗。比较患者在常规治疗30 min末、BiPAP治疗后1 h、2 h后收缩压、舒张压、心率、呼吸频率、二氧化碳分压（PaCO2）、动脉血氧分压（PaO2）等指标的变化，以及常规治疗30 min末、BiPAP治疗2h后的血浆脑钠肽（BNP）、血乳酸（Lac）水平和临床表现的变化。结果：经BiPAP治疗后患者症状和体征缓解的有效率为93.90%。BiPAP治疗1 h、2 h后与常规治疗30 min末比较，患者的收缩压、舒张压、心率、呼吸频率具有显著下降（P＜0.05），PaO2则显著升高（P＜0.05），PaCO2的变化经比较则无显著的统计学意义（P＞0.05）。BiPAP治疗2 h后患者的血浆BNP、Lac水平与常规治疗30 min末比较均显著下降（P＜0.05）。结论：BiPAP治疗尿毒症并发急性左心衰竭患者可有效改善患者的症状和体征，改善心功能，适合在临床上推广应用。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the clinical efficacy of Bi level positive airway pressure ventilation (BiPAP) in the treatment of uremic patients with left heart failure. Methods: 82 cases of patients diagnosed as uremia with left heart failure were selected from our hospital between January 2013 and March 2016. These patients were treated with conventional strong heart, diuresis, vasodilator, continuous renal replacement therapy (CRRT), and they were immediately given BiPAP therapy when no relief were observed at 30 min after previous treatment. Record and compare the systolic pressure, diastolic blood pressure, heart rate, respiratory rate, carbon dioxide partial pressure (PaCO2), arterial oxygen partial pressure (PaO2) and other indicators at 30 min after conventional treatment and 1 h, 2 h after BiPAP therapy. The plasma brain natriuretic peptide (BNP), blood lactic acid (Lac) levels and clinical features at 30 min after conventional treatment and 2 h after BiPAP treatment were also compared and analyzed. Results: The effective rate of symptoms and signs of the patients was 93.90% after BiPAP treatment. The systolic blood pressure, diastolic blood pressure, heart rate, respiratory rate has decreased significantly at 1 h, 2 h after BiPAP treatment, while PaO2 was raised remarkably, as compared with those at 30 min after conventional treatment (P < 0.05). Yet the PaCO2 changes had no statistical significance (P>0.05). The plasma levels of BNP and Lac were significantly decreased at 2 h after BiPAP treatment, compared with those at 30 min after conventional treatment (P < 0.05). Conclusion: BiPAP treatment could effectively improve symptoms and signs and heart function of uremia patients complicated with acute left heart failure, so it is worth of clinical application. |
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