无创性双水平正压通气抢救淹溺后肺水肿的疗效观察

Observation of therapeutic effect of BiPAP in the rescue of pulmonary edema caused by drowning

目的:探讨无创性双水平正压通气(BiPAP)抢救淹溺后肺水肿的疗效。方法:对38例淹溺后肺水肿患者在常规抢救的同时应用BiPAP呼吸机,选择S/T模式正压通气治疗,观察通气前后动脉血气分析中pH、PaO2、SaO2以及HR、RR、SBP、DBP和临床症状的变化。结果:通气治疗后,38例患者临床症状明显改善,血气分析中pH、PaO2、SaO2等与治疗前比较,有显著性差异(P<0.05),避免了气管插管机械通气。结论:应用无创性BiPAP呼吸机通气治疗溺水后肺水肿,熟练掌握BiPAP呼吸机的操作,根据病情及时调整BiPAP呼吸机的参数,确保患者的有效通气,可迅速改善患者症状和低氧血症。无创性BiPAP呼吸机通气不失为抢救溺水后肺水肿的一种安全、有效的方法。

Objective： To discuss the curative effect of BiPAP in the rescue of pulmonary edema caused by drowning. Methods： 38 cases of pulmonary edema patients caused by drowning treated with BiPAP when accepted routine therapy, choosed the S/T pattern. Then detected the indexes such as pH, PaCO2, SaO2, HR, RR, PaCO2, SaO2 and clinical symptoms change before and after ventilation. Results： After ventilation treatment,clinical symptoms had distinct improvement,blood gas analysis showed that pH, PaCO2, SaO2 had the remarkable difference compared with them before ventilation （P〈0.05）, and avoided the mechanical ventilation by trachea cannula. Conclusion： If operating the BiPAP breathing machine smoothly, adjusting the breathing parameter promptly,to ensure the effective ventilation,BiPAP ventilation can effectively improve the symptom and hypoxemia of patients with pulmonary edema caused by drowning.BiPAP is a kind of effective and safe method for rescue of pulmonary edema caused by drowning.