早期使用机械通气治疗重症急性左心衰竭对住院病死率的影响

目的探讨在重症急性左心衰竭患者中早期应用机械通气对住院病死率的影响。方法2006年10月-2008年10月,2年来我科对重症急性左心衰竭采用早期机械通气方法治疗的63例患者作为治疗组;2004年6月-2006年9月未采用早期机械通气治疗的重症急性左心衰竭患者59例作为对照组。观察治疗0,2,24h后2组患者的血气分析指标、氧合指数及住院天数和住院病死率。结果①治疗组患者机械通气0,2,24h后PaO2、PaCO2、氧合指数较对照组改善,住院天数缩短,差异有统计学意义,P〈0.05。②血pH值较对照组亦有所改善,但差异无统计学意义,P〉0.05。③住院期间病死率治疗组较对照组低,差异有统计学意义,P〈0.05。结论早期机械通气能改善急性左心衰竭并呼吸衰竭患者的氧合状态,显著降低病死率。

The effect of early mechanical ventilation for severe acute left ventricular failure on in-patient fatality rate

Objective To investigate the effect of early mechanical ventilation treatment in patients with severe acute left ventricular failure on in-patient fatality rate. Methods 63 patients with severe acute left ventricular failure treated with early mechanical ventilation from October, 2006 to October, 2008, were included in the treatment group. 59 cases of patients with the same disease and without receiving the early mechanical ventilation treatment from June, 2004 to September, 2006 were assigned to control group. The blood gas analysis indicators, oxygenation indexes, hospitalized days and fatality rate after receiving Oh, 2h, 24h treatment were observed and analyzed. Results①The PaO2, PaCO2, oxygenation indexes of patients in treatment group after Oh, 2h, 24h treatment were improved compared with those of patients in control group, and the hospitalized days of treatment group patients were shorter. The differences were significant statistically （P〈0.05）. ②The pH value of blood in the treatment group was also improved, but there was no significant difference between the two groups （P〉0.05）. ③The in-patient fatality rate in treatment group was lower significantly than that in control group （P〈0.05）.Conclusion Early mechanical ventilation treatment can improve the oxygenation of patients with acute left ventricular failure and respiratory failure and reduce their fatality rate significantly.