Effect of morphine combined with noninvasive positive pressure ventilation in the treatment of patients with acute left heart failure / 中国基层医药

ABSTRACT

Objective To investigate the effect of morphine combined with noninvasive positive pressure ventilation in the treatment of patients with acute left heart failure .Methods 80 patients with acute left heart failure were enrolled ,and they were randomly divided into two groups according to the digital table method ,40 cases in each group.The patients in the control group were treated with noninvasive positive pressure mechanical ventilation .The patients in the observation group were treated with morphine sedation on the basis of the treatment of the control gorup.The vital signs test indicators,disease-related parameters,clinical events,cognitive function and quality of life were compared between the the two groups .Results The systolic blood pressure,heart rate,respiratory rate,PaCO2 and myocardial oxygen consumption in the observation group were significantly lower than those in the control group at 30min after treatment,PaO2 and pH in the observation group were significantly higher than those in the control group , the APACHEⅡ,BNP,Hs-cTnl and CK levels in the observation group at 24 h after treatment were significantly lower than those in the control group,the differences were statistically significant (t =8.349,13.127,7.413,17.072, 15.334,2.631,3.088,12.371,8.061,4.784,18.931,6.568,9.464,all P<0.01).The rate of tracheal intubation of the observation group was significantly lower than that of the control group (0.0％vs.20.0％),the rate of withdrawal of the observation group was significantly higher than that of the control group (85.0％ vs.50.0％),the differences were statistically significant (χ2 =6.806,11.168,all P<0.01).The MLHFQ score of the observation group 3 months after treatment was significantly lower than that in the control group [( 24.69 ±5.38)points vs.( 38.24 ± 8.03)points],the difference was statistically significant (t=8.866,P<0.01).There was no statistically significant difference in MoCA score after treatment between the two groups [(24.80 ±2.93)points vs.(25.07 ±2.33)points, t=0.456,P>0.05].Conclusion Morphine has significant influence on the effect of noninvasive positive pressure mechanical ventilation in patients with acute left heart failure .