Tei指数评估BIPAP通气对急性心源性肺水肿患者心功能的影响

Assessment Cardiac Function of Acute Cardiogenic Pulmonary Edema Patients with BIPAP Mechanical Ventilation Therapy

目的运用Tei指数评估双水平正压通气(bilevelpositiveairwaypressure,BIPAP)通气对急性心源性肺水肿患者心脏整体功能的影响。方法31例急性心源性肺水肿患者入院后予BIPAP呼吸机治疗,以经口鼻面罩压力支持通气,以后逐渐减低压力水平直至脱离呼吸机。动态观察患者的心率、收缩压、呼吸频率、PaO2、PaCO2、PH等指标的变化。所有患者在机械通气前后均行心超检查,运用脉冲多普勒记录二尖瓣血流图以及左室流出道血流图,并计算Tei指数。结果经BIPAP呼吸机治疗后,心率、PaO2、患者症状有显著改善,机械通气前后Tei指数有显著性差异(0.74±0.07vs0.62±0.06,P<0.05)。结论BIPAP通气可明显改善急性心源性肺水肿患者心脏整体功能。

Objective Assessment cardiac function of acute cardiogenic pulmonary edema patients with BIPAP mechanical ventilation therapy. Methods 31 patients who with cardiogenic pulmonary edema were involve in this study. 31 cases received invasive mechanical ventilation until patients had stable clinic situation, all patients had done echocardiograph before and after BIPAP mechanical ventilation therapy. Results After BIPAP mechanical ventilation therapy, heart rate , Pa02 has significant change, and Tel index has significant difference （0.74 ± 0.07 vs 0. 62± 0.06, P 〈 0.05）. Conclusion Acute cardiogenic pulmonary edema patients receive BIPAP mechanical ventilation therapy benefit to these patients cardiac function improve.