无创通气在治疗急性心肌梗死合并心力衰竭的应用效果及对心功能的影响
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摘要
目的探究无创通气治疗急性心肌梗死(AMI)合并心力衰竭的应用效果及对心功能的影响。方法 82例AMI合并心力衰竭患者,根据治疗方法不同将其分为对照组与研究组,各41例。对照组患者行常规治疗,研究组患者在常规治疗基础上行无创通气治疗。观察两组血氧指标[血氧饱和度(SpO_2)、pH值、颈内静脉血氧饱和度(SivO_2)]以及心功能指标[左室舒张末内径(LVDD)、左心室射血分数(LVEF)、心脏泵功能分级(Killip分级)、B型尿钠肽(BNP)]变化情况。结果治疗后,两组患者p H值比较差异无统计学意义(P>0.05);研究组患者SpO_2、SivO_2显著高于对照组,差异具有统计学意义(P<0.05)。治疗后,研究组患者LVDD为(49.74±4.51)mm、LVEF为(49.65±11.27)%、BNP为(713.52±225.19)ng/L,均优于对照组患者的(59.47±6.38)mm、(41.42±8.69)%、(1786.37±316.85)ng/L,差异具有统计学意义(P<0.05)。对照组患者Killip分级中Ⅱ级+Ⅰ级为46.34%(19/41),低于研究组患者的75.61%(31/41),差异具有统计学意义(χ~2=7.38,P<0.05)。结论 AMI并心力衰竭患者应用无创通气治疗可有效改善血氧饱和度以及心功能,具推广价值。
Objective To investigate the application effect of noninvasive ventilation in the treatment of acute myocardial infarction(AMI) complicated with heart failure and its influence on cardiac function. Methods A total of 82 patients with AMI and heart failure were randomly divided by different treatment methods into control group and research group, with 41 cases in each group. The control group was treated with conventional therapy, and the research group was treated with noninvasive ventilation on the basis of conventional therapy. Observation were made on blood oxygen index [blood oxygen saturation(Sp O2), p H value and internal jugular venous oxygen saturation(Siv O2)] and cardiac function index [left ventricular end diastolic diameter(LVDD), left ventricular ejection fraction(LVEF), cardiac pump function classification(Killip grade), and type B natriuretic peptide(BNP)] changes between two groups. Results After treatment, both groups had no statistically significant difference in p H value(P>0.05). The research group had obviously higher Sp O2 and Siv O2 than the control group, and the difference was statistically significant(P<0.05). After treatment, the research group had LVDD as(49.74±4.51) mm, LVEF as(49.65±11.27)% and BNP as(713.52±225.19) ng/L, which were al better than(59.47±6.38) mm,(41.42±8.69)% and(1786.37±316.85) ng/L in the control group, and their difference was statistically significant(P<0.05). The control group had lower proportion of class Ⅱ+Ⅰ by Killip classification as 46.34%(19/41) than 75.61%(31/41) in the research group, and their difference was statistically significant(χ2=7.38, P<0.05). Conclusion Application of noninvasive ventilation can effectively improve blood oxygen saturation and cardiac function in AMI complicated with heart failure, and it contains promotion value.
Objective To investigate the application effect of noninvasive ventilation in the treatment of acute myocardial infarction(AMI) complicated with heart failure and its influence on cardiac function. Methods A total of 82 patients with AMI and heart failure were randomly divided by different treatment methods into control group and research group, with 41 cases in each group. The control group was treated with conventional therapy, and the research group was treated with noninvasive ventilation on the basis of conventional therapy. Observation were made on blood oxygen index [blood oxygen saturation(Sp O2), p H value and internal jugular venous oxygen saturation(Siv O2)] and cardiac function index [left ventricular end diastolic diameter(LVDD), left ventricular ejection fraction(LVEF), cardiac pump function classification(Killip grade), and type B natriuretic peptide(BNP)] changes between two groups. Results After treatment, both groups had no statistically significant difference in p H value(P>0.05). The research group had obviously higher Sp O2 and Siv O2 than the control group, and the difference was statistically significant(P<0.05). After treatment, the research group had LVDD as(49.74±4.51) mm, LVEF as(49.65±11.27)% and BNP as(713.52±225.19) ng/L, which were al better than(59.47±6.38) mm,(41.42±8.69)% and(1786.37±316.85) ng/L in the control group, and their difference was statistically significant(P<0.05). The control group had lower proportion of class Ⅱ+Ⅰ by Killip classification as 46.34%(19/41) than 75.61%(31/41) in the research group, and their difference was statistically significant(χ2=7.38, P<0.05). Conclusion Application of noninvasive ventilation can effectively improve blood oxygen saturation and cardiac function in AMI complicated with heart failure, and it contains promotion value.
引文
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[10]晏中军.急性心肌梗死合并左心衰竭患者急救过程中应用无创正压通气的效果分析.中国当代医药,2016,23(25):35-37.
[11]韩自旺,王红宇.无创通气在治疗急性心肌梗死合并心力衰竭的应用效果.中国实用医药,2016,11(1):97-98.
[2]余文仲.无创正压通气在急性心肌梗死合并左心衰竭患者救治中的应用效果.现代诊断与治疗,2015,26(19):4336-4337.
[3]敖红丽.无创通气治疗慢性阻塞性肺疾病急性发作合并呼吸衰竭的疗效分析.当代医学,2017,23(14):39-41.
[4]曹在新.无创正压通气治疗急性心梗并心力衰竭患者的临床疗效.医药论坛杂志,2014,35(11):130-131.
[5]申前进,阳文新,吴飞,等.早期无创通气在抢救急性左心衰竭合并呼吸衰竭患者中的临床应用.东南国防医药,2017,19(1):34-36.
[6]陈开祥,周新华,孙成爱.无创正压通气在急性心力衰竭中的临床应用.蚌埠医学院学报,2016,41(1):32-34.
[7]孔万权,徐强,魏大臻,等.无创通气治疗急性心肌梗死合并急性左心衰竭疗效观察.中国现代医生,2011,49(9):21-23.
[8]牟雄能,郑春连.无创正压通气在急性心肌梗死合并左心衰竭临床急救中的应用效果.中国急救医学,2012,32(11):1051-1053.
[9]兰发定,周桂芝.无创正压通气在老年急性心肌梗死合并左心衰竭中的应用.中国老年学,2012,32(23):16-17.
[10]晏中军.急性心肌梗死合并左心衰竭患者急救过程中应用无创正压通气的效果分析.中国当代医药,2016,23(25):35-37.
[11]韩自旺,王红宇.无创通气在治疗急性心肌梗死合并心力衰竭的应用效果.中国实用医药,2016,11(1):97-98.