无创双水平气道正压通气治疗急性心源性肺水肿临床观察

The Treatment of Acute Cardiogenic Pulmonary Edema with Noninvasive Bi-level Positive Airway Pressure Ventilation

目的:研究无创双水平气道正压通气对急性心源性肺水肿的治疗效果。方法:选择20例经常规方法治疗无效的急性心源性肺水肿患者进行BiPAP,记录临床症状、体征、彩色多普勒二维超声心动图、血气分析等指标监测。结果:20例急性心源性肺水肿患者抢救成功18例次,抢救成功率90%。治疗2h后生命体征稳定、心衰减轻,PaO2明显提高(P<0.01)。3d后心脏射血分数明显增加(P<0.01)。结论:BiPAP通过调节适当压力水平,可改善心功能,减轻肺水肿,迅速提高血氧含量。

Objective： To evaluate the effects of noninvasive bi - level positive airway pressure ventilation, Methods： 20 patients with acute cardiogenic pulmonary edema was treated with noninvasive bi- level positive airway pressure ventilation. Clinical symptoms, signs, two - dimersional color Doppler echocardiogram and blood gas analysis were monitored. Results： 18 patients survived with a success rate of 90%. Significant improvements of vital signs, PaO2 was foand（ P 〈 0.01 ）4 hours after ventilation. Ejection fraction was improved markedly （ P 〈 0.01 ）3 days after ventilation. Conclusion： Noninvasive bilevel positive airway pressure venti- lation can decrease the pulmonary edema , elevate PaO2 and promptly improve heart function.