發(fā)布時間：2018-03-27 19:56

  本文選題：正壓呼吸　切入點：子癇　出處：《中國循環(huán)雜志》2015年12期

【摘要】：目的:探討雙水平氣道正壓(BiPAP)無創(chuàng)通氣輔助治療重度子癇前期合并急性心力衰竭(AHF)的臨床療效。方法:回顧性分析2008-01至2014-12我科收治的84例重度子癇前期合并AHF患者的臨床資料,其中41例采用重度子癇前期及AHF的常規(guī)治療(對照組),43例在對照組治療基礎(chǔ)上加用BiPAP通氣輔助治療(觀察組),評估兩組患者治療前及治療后3h發(fā)紺、呼吸困難、肺部Up音、心率、呼吸、動脈血氧飽和度(SaO_2)、動脈血氧分壓(PaO_2)、動脈二氧化碳分壓(PaCO_2)、pH值及B型利鈉肽(BNP)等指標變化情況。結(jié)果:(1)觀察組和對照組患者治療后與治療前比較:心率(次/min,對照組:90±8 vs 110±14、觀察組:80±6 vs 112±12)、呼吸(次/min,對照組:24±5 vs 33±8,觀察組:18±4 vs 35±7)、PaCO2(mmHg,對照組:41.3±4.3 vs 48.4±5.6、觀察組:29.7±5.4 vs47.8±3.9)及BNP(ng/L,對照組:87.50±8.00 vs 133.00±8.00、觀察組:69.50±8.30 vs 138.00±6.92)均下降,SaO_2(%,對照組:93.0±3.7 vs 80.5±4.7、觀察組:97.1±3.4 vs 81.2±4.2)、PaO_2(mmHg,對照組:80.3±5.8 vs 80.5±4.7、觀察組:89.1±6.2 vs 53.2±5.4,1 mmHg=0.133 kPa)均升高,差異均具有統(tǒng)計學意義(P均0.05)。(2)觀察組與對照組治療后比較:心率、呼吸、PaCO_2及BNP明顯下降,SaO_2及PaO_2明顯升高,差異均有統(tǒng)計學意義(P均0.05);治療后兩組pH值比較,差異無統(tǒng)計學意義(P0.05)。結(jié)論:BiPAP輔助治療重度子癇前期并發(fā)AHF可改善患者的心衰癥狀和低氧血癥。其臨床意義尚須前瞻性臨床研究加以證實。
[Abstract]:Objective: to investigate the clinical efficacy of BiPAP-based non-invasive ventilation in the treatment of severe preeclampsia complicated with acute heart failure. Methods: the clinical data of 84 patients with severe preeclampsia complicated with AHF from January 2008 to December 2014-12 were retrospectively analyzed. Among them, 41 cases were treated with routine treatment of severe preeclampsia and AHF (control group 43 cases were treated with BiPAP ventilation on the basis of control group) (observation group, the patients in both groups were evaluated for cyanosis, dyspnea, pulmonary up sound before treatment and 3 h after treatment. Heart rate, breathing, The changes of arterial oxygen saturation (SAO _ 2), Pao _ (2), PaCO _ (2) pH and B type natriuretic peptide (BNPs) were compared between the observation group and the control group after treatment. Weight 90 鹵8 vs 110 鹵14, observation group 80 鹵6 vs 112 鹵12, respiration: 24 鹵5 vs 33 鹵8, observation group: 18 鹵4 vs 35 鹵7 Paco _ 2mm Hg, control group: 41.3 鹵4.3 vs 48.4 鹵5.6, observation group: 29.7 鹵5.4 vs47.8 鹵3.9, control group 87.50 鹵8.00 vs 133.00 鹵8.00, observation group 69.50 鹵8.30 vs 138.00 鹵6.92), control group: 93.0 鹵3.7 vs 80.5 鹵4.7, observation group 93.4 鹵3.4 vs 81.2 鹵4.2mm HG, control group 87.50 鹵8.30 vs 8.30 鹵6.92mm, control group 93.0 鹵3.7 vs 80.5 鹵4.7, observation group 93.4 鹵3.4 vs 81.2 鹵4.2mm HgP, control group 87.50 鹵8.30 鹵8.30 鹵6.92mm, control group 93.0 鹵3.7 vs 80.5 鹵4.7mm / h, control group: 87.50 鹵8.00 vs 133.00 鹵8.00, control group: 69.50 鹵8.30 vs 138.00 鹵6.92mm / g; control group: 93.0 鹵3.7 vs 80.5 鹵4.7mm / g; % 80.3 鹵5.8 vs 80.5 鹵4.7; the observation group: 89.1 鹵6.2 vs 53.2 鹵5.4 mmHg=0.133 KPA; Compared with the control group after treatment, the heart rate, Paco _ 2 and BNP in the observation group were significantly lower than those in the control group, and the levels of SaO2 and PaO_2 were significantly higher than those in the control group (P < 0.05), and the pH values of the two groups were compared after treatment. There was no significant difference (P 0.05). Conclusion the clinical significance of the adjunctive treatment of AHF in patients with severe preeclampsia can improve the symptoms of heart failure and hypoxemia, and its clinical significance should be confirmed by prospective clinical studies.
【作者單位】： 內(nèi)蒙古民族大學附屬醫(yī)院婦產(chǎn)科;
【分類號】：R714.2

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本文編號：1673006