无创通气治疗淡水淹溺引起的急性肺水肿的疗效观察

The Treatment of Acute Pulmonary Edema of Drowning in Fresh Water With Noninvasive Positive Pressure Ventilation

目的研究无创正压通气(noninvasive posttive pressure ventilation,简称NIPPV)对淡水淹溺引起的肺水肿的治疗效果。方法26例淡水淹溺患者随机分为两组,对照组13例,采用常规治疗;试验组13例,在常规治疗的基础上给予NIPPV,观察临床表现、胸部X线片和动脉血气变化。结果试验组在治疗24 h后,呼吸频率由(35±8)次/min降至(18±4)次/min(p<0.05),心率由(120±20)次/min降至(85±20)次/min(p<0.05),胸片恢复至正常时间、肺部啰音消失时间及住院时间均明显小于对照组,差异均有统计学意义(p<0.01或p<0.05)。结论药物加NIPPV治疗溺水引起的急性肺水肿比常规治疗能更快改善患者的临床症状和低氧血症。NIPPV是溺水患者的重要治疗措施。

Objective To evaluate the effects of noninvasive positive pressure ventilation （NIPPV） on acute pulmonary edema by drowning in fresh water. Method 26 patients with acute pulmonary edema by drowning were randomly divided into two groups. 13 patients in control group just received Conventional treatment and 13 patients in treatment group received NIPPV based on conventional treatments. The symptoms, signs, chest X-ray appearance,arterial blood gas analysis. Results 24 h after noninvasive positive pressure ventilation respiratory rates decreased from（38 ± 8） times/min to （18± 4） times/min （p〈0.05）, heart rates decreased from （120±20）times/min to（85±20）times/min （p〈0.05）. The time of chest X-ray been normol,lung moist rale disappeared and in-patient was markedly shorter,and the differences were statistically signifieant（p〈0.01 or p〈0. 05）. Conclusion Drug and NIPPV can improve symptoms, hypoxemia of acute pulmonary edema by drowning more rapidly than conventional therapy. NIPPV is the important therapy of drowning patient.