无创机械通气联合硝普钠治疗急性心源性肺水肿

Non-invasive mechanical ventilation combined with nitroprusside sodium for treatment of acute cardiac pulmonary edema

目的：观察无创机械通气联合硝普钠治疗急性心源性肺水肿的疗效。方法：将符合心源性肺水肿诊断标准的患者33例,随机分为无创机械通气联合硝普钠治疗组（A组）、硝普钠治疗组（B组）和常规治疗组（C组）,每组11例。观察治疗前后患者心率（HR）、呼吸频率（R）、平均动脉压（MAP）、血氧饱和度（SpO2）、末梢转暖时间,并结合临床症状、肺部罗音判断疗效。结果：A组与B组、C组相比,治疗15 min后R开始下降、SpO2上升（P〈0.05-P〈0.01）,治疗60 min后MAP明显下降（P〈0.01）,能提高抢救总有效率（P〈0.05）。结论：无创机械通气联合硝普钠治疗急性心源性肺水肿能降低患者R及MAP水平,改善SpO2,明显提高抢救有效率,降低无效率。

Objective：To investigate the curative effect of non-invasive mechanical ventilation combined with nitroprusside sodium on acute cardiac pulmonary edema（ACPE）. Methods：Thirty-three cases of ACPE were collected and divided randomly into group A（ non-invasive mechanical ventilation combined with nitroprusside sodium therapy ） , group B （ nitroprusside sodium therapy） and group C （conventional therapy）. The heart rate （HR）, respiratory rate （R）, mean arterial pressure （MAP） and saturation of blood oxygen （ SpO2 ） of all the patients were measured before and after treatment, and the curative effect was judged according to the symptoms and lung rattle. Results：Compared with group B and C, R in group A decreased and SpO2 rose after treatment for more than 15 minutes（P 〈 0.05 to P 〈 0.01 ）, and the MAP decreased obviously 60 minutes later（ P 〈 0.01 ） ;group A could obviously raise the success rate of salvage and shorten the salvage time compared to group B and C （ P 〈 0.05 ）. Conclusions ： Non-invasive mechanical ventilation combined with nitroprusside sodium can obviously decrease the RR and MAP, improve the SpO2 , raise the success rate of salvage and shorten the salvage time in treating patients with ACPE.