双水平无创正压通气治疗急性心源性肺水肿

Clinical study of non-invasive bi-level positive airway pressure ventilation in the treatment of acute cardiogenic pulmonary edema

目的通过双水平无创正压通气治疗急性左心衰竭肺水肿患者,探讨无创机械通气应用于急性心源性肺水肿治疗的疗效。方法41例急性左心衰竭肺水肿患者应用双水平无创机械通气治疗,观察治疗前后临床症状、体征、血气分析结果、急性生理与慢性健康评分(APACHE)Ⅱ以及胸部X线的改善情况。结果41例患者经双水平无创机械通气后呼吸频率、心率、血气分析结果及APACHEII均有明显的好转改变(P<0.05),临床症状好转,胸部X线显示肺水肿情况改善。结论双水平无创机械通气治疗急性心源性肺水肿患者,取得了较满意的疗效,是一种较为理想的治疗措施。

Objective To assess the effectiveness of non - invasive bi-level positive airway pressure （BiPAP） ventilation on acute cardiogenic pulmonary edema. 0. Bingfeng ease. Methods 41 patients with acute left heart failure with cardiogenic pulmonary edema, who were treated by BiPAP and traditional drugs. The changes of clinical symptoms, signs, arterial blood gas results, acute physiology and chronic health evaluation （ APACHE Ⅱ）, and X-ray chest films, which were evaluated for the efficacy. Results The total 41 cases of acute pulmonary edema got improved therapeutic results after BiPAP ventilation. RR, MBP, HR, arterial blood gas results, PaO2/FiO2, and APACHE II were showed statistical significance （ P 〈 0. 05 ） between prior and post treatment. Conclusion Non-invasive BiPAP ventilation is an effective and desirable therapeutic in patient s with acute cardiogenic pulmonary edema.