双相气道正压面罩通气治疗急性心源性肺水肿

The use of noninvasive bilevel positive irway pressure treatment of acute cardiogenic pulmonary edema

目的 探讨应用双相气道无创正压面罩通气(Bipap)在治疗 ,急性肺水肿的临床价值。方法 对 2 7例难治性心源性肺水肿的患者应用Bipap呼吸机治疗通过观察治疗前后患者的心率、呼吸频率、血压、尿量、氧分压、二氧化碳分压、血氧饱和度及心功能等指标变化。结果 患者经 3～ 10h的无创正压通气治疗心率、呼吸频率明显减慢 (P <0 0 5 ) ,尿量明显增加 (P <0 0 5 ) ,氧分压血氧饱和度明显提高 (P <0 0 5 ) ,心功能明显改善。结论 双相气道正压通气(Bipap)治疗急性心源性肺水肿是安全、有效 ,值得临床上推广应用。

Objectives To evaluate the clinical applications of noninvasive bilevel positive airway pressure in the treatment of acute cardiogenic pulmonary edema. Methods 27 patients with acute cardiogenic pulmonary edema were treated with bilevel positive airway pressure (BiPAP). Before and after ventilatory support, the heart rate, breating rate, urine volume, PaO 2, PaCO 2, SaO 2 and heart function were recorded. Results After 3～10 hour treatment, the heart rate and breathing rate were significantly reduced (P<0.05). The urine volume, PaO 2 and SaO 2 were markedly increased (P<0.05). The heart function in all patients was improveed. Conclusions The use of noninvasive bilevel positive airway pressure treatment of acute cardiogenic pulmonary edema is safe and effective. It can be recommended for clinical use.