无创正压通气治疗老年重症急性心源性肺水肿的疗效观察

Therapic effect of noninvasive positive pressure ventilation in treatment of severe acute cardiogenic pulmonary edema

目的:观察无创正压通气(NIPPV)治疗老年重症急性心源性肺水肿(SACPE)的临床疗效。方法:38例老年SACPE患者(心功能NYHAⅢ～Ⅳ级)随机分两组,对照组17例,采用常规治疗;治疗组21例,在常规治疗的基础上给予NIPPV治疗;分别记录两组治疗前后的临床表现,治疗前及治疗后0.5、1、2 h动脉血气、心率、呼吸频率、胸部X线等参数的变化,并作统计学分析。结果:治疗组NIPPV治疗30 min后呼吸困难明显改善,呼吸频率和心率明显下降,肺部湿性罗音消失明显,总体好转程度明显优于对照组,PaO2升高的程度和幅度均优于对照组。结论:NIPPV治疗老年SACPE的疗效肯定、快速、安全。

Objective： To observe the effect of noninvasive positive pressure ventilation （NIPPV） on senile severe cardiogenic pulmonary edema（SACPE）. Methods：Thirty-eight cases with SACPE were randomly divided into treatment group and control group. Seventeen cases in control group were administered just conventional therapy,while the 21 cases in treatment group received NIPPV in addition to the conventional therapy. The cases＇ arterial blood gases analysis, heart rates, respiratory rates and chest X-ray appearance were monitored and analyzed. Results： Thirty minutes after the application of NIPPV, the patients＇ dyspnea was improved markedly, respiratory rates and heart rates decreased, and moist rale disappeared rapidly. The patients in the treatment group improved more rapidly than those in control group. The arterial blood gas analysis showed that the PaO2 rosed more quickly in the treatment group than in the control group. Conclusions：NIPPV is a safe and effective method for treatment of SACPE.