目的 观察芪参益气滴丸联合经鼻高流量湿化氧疗对老年心力衰竭患者血气指标、生命体征以及心功能的影响。方法 选择纽约心功能分级Ⅲ～Ⅳ级的左心衰竭患者45例，随机分为对照组25例和观察组20例，对照组应用常规抗心衰治疗联合经鼻高流量湿化治疗仪辅助通气，观察组在对照组基础上口服芪参益气滴丸。观察并比较两组患者的临床疗效以及不同时间点的血气指标、生命体征及心脏功能。结果 对照组患者的有效率为44。00％(11/25)，观察组患者的有效率为75。00％(15/20)，与对照组比较，观察组的有效率明显升高(P＜0。05)。治疗前，两组患者的各生命体征及血气指标水平均无明显差异(P＞0。05)。在治疗24 h后，与对照组比较，观察组患者动脉血氧分压(arterial partial pressure of oxygen，PaO2)、二氧化碳分压(arterial partial pressure of carbon dioxide，PaCO2)以及酸碱度(pondus Hydrogenii，pH)等血气指标与平均动脉压(mean arterial pressure，MAP)、心率(heart rate，HR)、呼吸频率(respiratory rate，RR)等生命体征差异均无统计学意义(P＞0。05);治疗72 h后，与对照组比较，观察组患者的PaO2水平显著升高，而PaCO2显著下降，差异具有统计学意义(P＜0。05，P＜0。01);但两组患者的pH值差异无统计学意义(P＞0。05)。治疗72 h后，观察组患者的MAP、HR和RR水平相较于对照组均明显降低，差异具有统计学意义(P＜0。05)。治疗完成后，相较于对照组，观察组患者的左心室舒张末期内径(left ventricular end diastolic dimension，LVDD)、左室收缩末期内径(left ventricular end systolic diameter，LVDS)水平均明显降低，而左室射血分数(left ventricular ejection fraction，LVEF)水平则明显升高(P＜0。01)。两组患者的气管插管病例数和入住ICU病例数均差异无统计学意义(P＞0。05)，但相较于对照组，观察组患者的住院天数显著减少，差异具有统计学意义(P＜0。05)。结论 芪参益气滴丸联合经鼻高流量湿化氧疗治疗老年心力衰竭具有良好的临床疗效，在改善患者的心衰症状和血氧饱和度同时，通过进一步提高其心功能。
Qishen Yiqi Dripping Pills(芪参益气滴丸)Combined with Nasal High Flow Humidifying Oxygen Therapy for Senile Heart Failure:A Single-Center Clinical Control Study
Objective To observe the effects of Qishen Yiqi Dripping pills(芪参益气滴丸)combined with nasal high-flow humidifying oxygen therapy on blood gas indexes,vital signs and cardiac function in elderly patients with heart failure.Method Forty-five patients with New York Grade Ⅲ～Ⅳ left heart failure were selected and randomly divided into control group(25 cases)and observation group(20 cases).The control group was treated with routine anti-heart failure therapy com-bined with nasal high-flow humidification therapy apparatus assisted ventilation.The observation group was given Qishen Yiqi Dripping Pills on the basis of the control group.The clinical efficacy,blood gas indexes,vital signs and heart function at different time points were observed and compared between the two groups.Results The effective rate of the control group was 44.00％(11/25),and that of the observation group was 75.00％(15/20),which was significantly higher than that of the control group(P＜0.05).Before treatment,there were no significant differences in the levels of vital signs and blood gas indexes between the two groups(P＞0.05).After 24 h of treatment,compared with those of the control group,the values of blood gas indexes such as arterial partial pressure of oxygen,arterial partial pressure of oxygen,arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2)and pH,and vital signs such as mean arterial pressure(MAP),heart rate(HR)and respira-tory rate(RR)had no significant difference(P＞0.05).After 72h of treatment,compared with those of the control group,the PaO2 value in the observation group was significantly increased,while the PaCO2 value was significantly decreased,and the differ-ence was statistically significant(P＜0.05,P＜0.01).However,there was no significant difference in pH between the two groups(P＞0.05).After 72 h of treatment,the levels of MAP,HR and RR in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P＜0.05).After treatment,the left ventricular end diastolic dimension(LVDD)and left ventricular end systolic diameter(LVDS)were significantly decreased,while the levels of left ventric-ular ejection fraction(LVEF)was significantly increased(P＜0.01).There was no significant difference between the two groups in the number of tracheal intubation cases and the number of ICU patients(P＞0.05),but compared with those of the control group,the hospitalization days of patients in the observation group were significantly reduced with statistical significance(P＜0.05).Conclusion Qishen Yiqi Dripping Pills combined with nasal high flow humidifying oxygen therapy has good clinical effica-cy in the treatment of senile heart failure,improving the symptoms of heart failure and blood oxygen saturation while further impro-ving the cardiac function.
heart failureold agenasal high flow humidifying oxygen therapyQishen Yiqi Dropping Pills(芪参益气滴丸)cardiac functionclinical research
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