双水平正压通气在急性心源性肺水肿中的应用

Treatment of Acute Cardiogenic Pulmonary Edema with Bilevel Positive Airway Pressure Ventilation via Nasal/Face Mask

目的探讨急性心源性肺水肿(ACPE)使用经鼻/面罩双水平正压通气(BiPAP)的救治方法。方法分析42例ACPE并发呼吸衰竭患者,经鼻/面罩连接呼吸机BiPAP无创通气救治,据患者反应调节呼吸机参数,2h好转后,分析比较治疗前后心功能分级改善情况,平均动脉压(MAP)、心率(HR)、呼吸频率(RR)、SpO2和动脉血气:PH、氧分压(PaO2)、二氧化碳分压(PaCO2)的变化。结果 BiPAP治疗2h后患者的MAP、HR、RR、SpO2和动脉血气中PH、PaO2较治疗前均改善显著,差异有统计学意义(P<0.05)。结论经鼻/面罩连接BiPAP无创通气可作为ACPE合并呼吸衰竭患者的首选治疗措施之一。尽早正确使用可以使许多ACPE患者避免有创通气。

Objective To discuss the treatment of acute cardiogenic pulmonary edema with bilevel positive airway pressure ventilation via nasal/face mask.Methods According individual pa-tient’s need to adjust the machine’s parameters,42 patients with acute cardiogenic pulmonary edema were treated by（BiPAP） ventilation via nasal/face mask.When every patient became melioration after 2 hours treatmentt,o analyze the differences of patients’heart function and the differences of mean arteri-al pressure（MAP）,heart rate（HR） r,espire rate（RR）,SpO2.At the same time to analyze the differ-ences of arterial PH,PaO2 and PaCO2.Results Significant differences were found between 2 hours treatment by BiPAP ventilation via nasal/face mask in HR,RR,MAP,SpO2（P 〈0.01）.Significant differences were showed between 2 hours treatment by BiPAP ventilation via nasal/face mask in arterial PH,PaO2（P 〈0.05）.No significant difference is arterial PaCO2.Conclusion These results suggest that the treatment of ACPE with BiPAP ventilation via nasal/face mask is a important available meth-od.In most of ACPE,early use this method can avoid invative ventilation.