无创正压通气在急性心肌梗死并发急性肺水肿中的临床应用

Clinical application of Non-invasive positive pressure ventilation in acute pulmonary edema complicated with acute myocardial infarction

目的探讨无创正压通气在急性心肌梗死并发急性肺水肿中的临床应用价值。方法选择急性心肌梗死并发急性肺水肿患者70例,根据治疗方法的不同分为观察组和对照组,对照组患者采用常规治疗,在常规治疗的基础上,观察组患者应用无创正压通气治疗。结果 (1)治疗后,观察组患者PaO2、PaCO2、SaO2、RR、HR及SBP的改善程度优于对照组,它们之间均有统计学差异(P<0.05)。(2)治疗1 d后,观察组患者N端脑钠肽前体水平较治疗前显著降低,亦显著低于对照组,它们之间均有统计学差异(P<0.01)。(3)观察组患者中转为气管插管及死亡的比例均显著低于对照组(P<0.05)。观察组患者平均住院时间显著短于对照组(P<0.05)。结论在急性心肌梗死并发急性肺水肿的治疗中,无创正压通气具有很高的应用价值。

Objective To explore the clinical application of Non-invasive positive pressure ventilation in acute pulmonary edema complicated with acute myocardial infarction. Methods 70 patients with acute pulmonary edema complicated by acute myocardial infarc- tion were divided into two groups, the control group were treated with conventional treatment and the observation group were treated with noninvasive positive pressure ventilation on the basis of conventional treatment. Results 1. After treatment, the PaO2 , PaCO2 , SaO2 , RR, HR and SBP of the observation group improvement better than those in the control group, there were statistically significant （ P 〈 O. 05 ）. 2. After I d＇s treatment, the N-terminal brain natriuretic peptide levels of the observation group were significantly lower than those of before treatment and the control group, there were significant differences （ P 〈 0. O1 ）. 3. The proportion of patients endotracheal intuba- tion and death of the observation group were significantly lower than those of the control group （P 〈0. 05）. The average length of stay in observation group was significantly shorter than that in the control （P 〈 0. 05 ）. Conclusion In the treatment of acute pulmonary edema complicated with acute myocardial infarction, noninvasive positive pressure ventilation has high value.