超声评价无创呼吸机对急性左心衰竭患者心功能的影响

The Effect of Noninvasive Ventilator on Cardiac Function in Patients with Acute Left Heart Failure by Echocardiography

摘要: 目的：应用超声心动技术评价无创呼吸机对急性左心衰竭患者心功能的影响。方法：对40例急性左心衰竭患者在常规治疗不能有效改善低氧血症时，使用双水平正压通气(BiPAP)治疗，检测应用前后患者血压、心率、呼吸与动脉血气等参数，采用床旁超声心动图测定左室射血分数(LVEF)、二尖瓣舒张早期与舒张晚期血流峰值流速比值(E/A)及Tei指数。结果：40例患者在BiPAP治疗后呼吸困难明显减轻，血压、心率、呼吸与动脉血气等明显改善，治疗总有效率为92.5% (37/40)。治疗后Tei指数明显下降、LVEF明显升高及E/A升高，差异有统计学意义(P < 0.05)。结论：无创正压通气可以改善急性左心衰竭患者心功能，纠正低氧血症，超声心动技术能够无创、准确、综合地评价心脏整体功能。

Abstract: Objective: To evaluate the effect of noninvasive ventilator on cardiac function in patients with acute left heart failure by echocardiography. Methods: 40 patients of acute left heart failure received BiPAP mechanic ventilation treatment when the conservative treatment was not effective. The blood gas analysis, blood pressure, heart rate and breathing rate were observed before and after the treatment. Before and after BiPAP mechanical ventilation, left ventricular ejection fraction (LVEF), E/A and Tei index were measured by echocardiography. Results: The blood pressure, heart rate, breathing rate and blood-gas analysis of 40 patients significantly improved after BiPAP mechanical ventilation, and the effective rate was 92.5% (37/40). After treatment, the Tei index decreased significantly, LVEF was significantly elevated and E/A was elevated; the difference was statistically significant (P < 0.05). Conclusion: Noninvasive positive pressure ventilation can im-prove cardiac function and hypoxemia in patients with acute left heart failure. Echocardiography is a noninvasive, accurate and comprehensive imaging technology to evaluate the overall function of the heart.