无创正压通气治疗急性心原性肺水肿72例临床体会

Clinical observation of noninvasive positive pressure ventilation in 72 patients with acute cardiac pulmonary edema

目的:观察无创正压通气(NPPV)治疗急性心原性肺水肿的疗效。方法:对72例急性心原性肺水肿患者按照是否伴有明显的二氧化碳潴留,将其分为两组,PCO2>45mm Hg组和PCO2<45mm Hg组,两组再分为NPPV组和常规组,各18例。结果:PCO2>45mm Hg组中,NPPV治疗后呼吸频率、心率、动脉血氧饱和度及气管插管率显著改善,死亡率也有降低趋势,两组比较差异有统计学意义(P<0.05),而PCO2<45mm Hg组中,差异不明显。结论:对于无创通气治疗心原性肺水肿,当患者有明显的二氧化碳潴留时,疗效较好。

Objective： To study the effects on the treatment of acute cardiogenic pulmonary edema with noninvasive positive pressure ventilation. Methods： 72 patients with acute cardiogenic pulmonary edema were divided into two groups according to retention of carbon dioxide, the PCO2〉45 mm Hg and PCO2〈45 mm Hg group, and then each group was randomly divided into NPPV group （n=18） and control group （n=18）. Results： The respiratory rate, heart rate, oxygen saturation and the rate of endotracheal intubation were significantly improved in the PCO2〉45 iron Hg group with noninvasive positive pressure ventilation and the mortality also has decreasing trend （P〈0.05）, but in the PCO2〈45 mm Hg group, the difference was not remarkable. Conclusion： The effect would be better when patients have retention of carbon dioxide on the treatment of acute cardiogenic pulmonary edema with noninvasive positive pressure ventilation.