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·胸部疾病·

有创机械通气在老年急性左心衰并严重肺水肿治疗的疗效评价

作者:陈以明 翟永新 梁国泉 白建雄 全楚杰

所属单位:广东省肇庆市第二人民医院 (广东 肇庆 526060)

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摘要

目的 研究有创机械通气在老年急性左心衰并严重肺水肿治疗疗效的评价。方法 以我院2013年6月-2015年6月收治 的52例老年急性左心衰并严重肺水肿患者作为研究对象,通过对患者进行有创机械通气治疗,分析患者通气后的心 率、血压、呼吸频率等各项指标的变化。结果 在对患者进行6h、12h、48h通气治疗后,患者的各项观察指标均得 到有效的改善,呈现好转趋势。其中有47例患者成功的进行了有创机械通气的撤机,成功率为90.38%,5例患者通 气成功但有创机械通气撤机出现失败(4例患者撤机过程中死亡,1例患者撤机失败后转入外科),病死率为7.69%。 结论 给予老年急性左心衰并严重肺水肿患者有创机械通气治疗,能有效的降低病死率,临床疗效较好,值得推广 和应用。

Objective To evaluate treatment efficacy of the invasive mechanical ventilation in elderly patients with acute left ventricular failure and severe pulmonary edema. Methods 52 cases of elderly patients with acute left ventricular failure and pulmonary edema treated in our hospital from June 2013 to June 2015 were selected as the research object. Through patient invasive mechanical ventilation, heart rate analysis after the patient ventilation, blood pressure changes in respiratory rate and other indicators. Results The patient 6h, 12h, 48h after ventilation therapy, observed the patients have been effectively improved, showing improving trends. There are 47 patients were successful have invasive mechanical ventilation weaning of 90.38%. In 5 patients with ventilation success but there is a mechanical ventilation weaning failure (died in 4 patients weaning process. 1 patients weaning failure into surgery, the mortality rate was 7.69%. Conclusion To give elderly patients with acute left heart failure patients with severe pulmonary edema and invasive mechanical ventilation in the treatment, can effectively reduce the mortality rate, clinical curative effect better value to popularization and application.

【关键词】有机机械通气;肺水肿;老年急性左心衰;临床疗效

【中图分类号】R541

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2016.03.004

前言

急性左心衰是内科中较为常见的一种常见病,该 病的发展速度较快,且病死率相对较高[1]。急性心衰 可以在原有慢性心衰基础上急性加重或突然起病,发 病前患者多数合并有器质性心血管疾病,可表现为收 缩性心衰,也可以表现为舒张性心衰。急性心衰常危 及生命,急性左心衰合并心源性肺水肿的患者病死率 则更高,住院期间死亡率可达12%,1年死亡率高达 40%[2]。近年来医学上机械通气治疗运用较广泛,治 疗疗效显著。本文选用我院自2013年6月~2015年6月 收治的老年急性左心衰并严重肺水肿患者作为研究对象,对有创机械通气治疗的疗效进行分析,现报道如 下。