经面罩无创机械通气治疗急性心源性肺水肿

The treatment of acute cardiogenic pulmonary edema with noninvasive positive pressure ventilation

目的 探讨无创机械通气抢救急性心源性肺水肿的疗效。方法 将42 例急性心源性肺水肿患者随机分为两组,治疗组22例经面罩行无创机械通气,对照组20例给予高浓度面罩吸氧,两组均常规利尿、扩血管、强心和镇静治疗。结果 治疗组经无创机械通气2h后临床征象、动脉血气指标、心率和呼吸频率均明显好转并优于对照组(P<0.05),24h后比较差异无显著性(P>0.05)。结论 经面罩无创机械通气治疗急性心源性肺水肿起效快,能明显改善低氧血症,是抢救急性心源性肺水肿的重要手段之一。

Objective To evaluate the effects of noninvasive positive pressure ventilation (NIPPV) on acute cardiogenic pulmonary edema.Methods Fourty-two patients with acute cardiogenic pulmonary edema were randomly divided into two groups, 22 patients in treatment group received NIPPV based on conventional treatments, while 20 patients in control groups received conventional treatments and breathe oxygen via facial mask.Results Clinical symptoms, blood gas analysis, heart rates and respiratory rates 2h after NIPPV were improved obviously in treatment group, and the patients in treatment group improved more rapidly than those in control group (P<0.05).Conclusion NIPPV can improved hypoxemia more rapidly than conventional therapy and is one of the important means to rescue acute pulmonary edema.