无创正压通气对急性肺水肿疗效的观察

Obscrvation of noninvasive positive pressure ventilation for the treatment of acute pulmonary edema

目的观察天创正压通气对急性肺水肿低氧血症的疗效。方法选择15例心源性或非心源性急性肺水肿所致的低轨血症患者，进行无创正压通气，并行心电监护、有创动脉血压、血氧饱和度、呼吸频率、血气分析、尿量等指标的监测。结果15例急性肺水肝患者存活14例，死亡1例，抢救成功率93．33％。治疗2小时后患者由烦躁转入安静，。G率、呼吸频率减慢，氧分压明显提高，通气前后比较P＜0．05。结论无创正压通气，通过调节压力支持和呼气末正压水平，可降低肺间质和肺泡的渗出水肿，促进肺泡复张，改善通气血流比率，有利于气体弥散，从而提高动脉氧分压和氧饱和度。

Objective To observe noninvasive positive pressure ventilation for the treatment of acute pulmonary edema(APE). MethoIls 15 palients with hypoxaemia due to cardiogemic or non-cardiogenic APE received noninvasive positivepressure ventilation and were monitored under ECC. Observations were catried out about their traumatic arterial blood pressure,SaO2, respiratoy frequency, arterial blood gas analysis and urine volume. Result 14 patients survived and 1 died with successrate of 93. 33%. Afer 2-hour therapy, the patients stopped being irritable to become quiet, and their heart rate and respiratoryfrequency went down while their SaO2 went up. Conclusion Noninvasive positive pressure ventilation can decrease the pulmonary interstitial and alveolar edema through adjusting pressure support and end-respiratory positive pressure. It can alsopromote alveolar re-inflation, improve the rate of V/Q, facilitate gas diffusion, and improve PaO2 and SaO2