摘要
目的研究双水平气道正压通气(BiPAP)联合重组人脑利钠肽(rhBNP)在重症急性心力衰竭(AHF)抢救治疗中的作用。方法选取2016年6月~2018年3月在我院心内科CCU抢救治疗的150例重症AHF患者为研究对象,采用随机数字表法分为对照组和观察组,各75例。对照组单纯采用BiPAP治疗,观察组在对照组基础上联合rhBNP治疗,比较两组临床抢救有效率、治疗后血流动力学指标[心率(HR)、动脉血二氧化碳分压(PaCO2)、平均动脉压(MAP)、动脉血氧分压(PaO2)、血氧饱和度(SpO2)]、血浆N末端B型尿钠肽(NT-proBNP)、平均撤机时间、24 h平均尿量及并发症发生情况。结果观察组总有效率为90.67%,高于对照组的80.00%(P<0.05);治疗后观察组HR、MAP、PaCO2、NT-proBNP均低于对照组,PaO2、SpO2均高于对照组(P<0.05);观察组平均撤机时间短于对照组,24 h平均尿量大于对照组(P<0.05);观察组并发症发生率为4.00%,与对照组的5.33%比较,差异无统计学意义(P>0.05)。结论在重症AHF抢救治疗中应用BiPAP联合rhBNP可提高抢救总有效率,改善心衰症状和低氧血症,促进利尿,且不增加并发症,应用安全可靠。
Objective To study the role of bilevel positive airway pressure(BiPAP)combined with recombinant human brain natriuretic peptide(rhBNP)in the rescue treatment of severe acute heart failure.Methods 150 patients with severe AHF who were rescued and treated by CCU in our department of cardiology from June 2016 to March 2018 were selected as the research object,and were divided into a control group and an observation group with a random number table method,75 cases each.The control group was treated with BiPAP alone.The observation group was combined with rhBNP treatment on the basis of the control group to compare the clinical rescue efficiency,hemodynamic indexes[heart rate(HR),arterial blood carbon dioxide partial pressure(PaCO2),average artery Pressure(MAP),arterial blood oxygen partial pressure(PaO2),blood oxygen saturation(SpO2)],plasma N-terminal B-type urinary natriuretic peptide(NT-proBNP),average withdrawal time,average 24 h urine output and complications what happened.Results The total effective rate of the observation group was 90.67%,higher than that of the control group of 80.00%(P<0.05);after treatment,the observation group HR,MAP,PaCO2,NT-proBNP were lower than the control group,PaO2,SpO2 All were higher than the control group(P<0.05);the average withdrawal time of the observation group was shorter than that of the control group,and the average urine output at 24 h was greater than that of the control group(P<0.05);The complication rate was 4.00%,compared with 5.33%of the control group,the difference was not statistically significant(P>0.05).Conclusion The application of BiPAP combined with rhBNP in the rescue treatment of severe AHF can improve the total rescue efficiency,improve heart failure symptoms and hypoxemia,promote diuresis without increasing complications,and it is safe and reliable.
作者
宋予苹
魏来
陈斌
SONG Yu-ping;WEI Lai;CHEN Bin(Department of Emergency,Beijing Jiangong Hospital,Beijing 100054,China;Department of Cardiology,Beijing Jiangong Hospital,Beijing 100054,China)
出处
《医学信息》
2020年第7期152-153,共2页
Journal of Medical Information
