无创双水平气道正压通气治疗急性心源性肺水肿

The clinical efficacy study of bi-level positive airway pressure ventilation in acute respiratory failure for acute cardiogenic pulmonary edema

目的观察无创双水平气道正压(BiPAP)通气治疗急性心源性肺水肿(ACPE)所致急性呼吸衰竭的疗效。方法32例常规治疗无效的急性心源性肺水肿患者采用BiPAP通气治疗,观察治疗前后患者临床征象、心率、平均动脉压、呼吸频率及动脉血气的变化。结果BiPAP通气治疗后,27例患者的临床症状明显改善,心率、呼吸频率、平均动脉压和动脉血PaO2、SaO2等指标与治疗前比较均有显著差异(P<0.05)。结论早期合理应用BiPAP通气治疗能迅速改善急性心源性肺水肿患者的临床症状和低氧血症,避免了气管插管,是抢救急性心源性肺水肿的重要方法之一。

Objective To investigate the clinical efficacy of bi - level positive airway pressure ventilation （BiPAP） in acute respiratory failure for acute cardiogenic pulmonary edema. Method 32 patients with acute cardiogenic pulmonary edema（ACPE） who had no response to conventional treatment were treated with BiPAP. The changes of clinical symptoms, heart rate, mean arterial pressure, respiratory rate and arterial blood gas （PaO,PaCO2, SaO2 ） were measured to evaluate the efficacy of BiPAP. Results After BiPAP, the clinical symptoms of 27 patients had been improved significantly. Also, the clinical parameters showed a statistical differences （ P 〈 0.05 ） compared with those before treatment. Conclusions BiPAP could improve symptoms and hypoxemia in patients with ACPE. Endotracheal intubation could be avoided in the patients studied. It is one of the important means to rescue ACPE.