BIPAP呼吸机治疗急性左心功能不全的临床观察

Clinical observation of Bi-Level positive airway pressure in treatment of acute cardiogenic pulmonary edema

目的探讨无创双水平气道正压(BiPAP)通气治疗急性心源性肺水肿的临床疗效。方法 25例急性心源性肺水肿患者均采用常规治疗,在此基础上,加用无创双水平气道正压通气治疗。并观察通气前后临床症状、体征和相关指标的变化。结果 25例患者中,20例患者临床症状明显改善,治疗后血pH、PaCO2、SaO2及PaO2/FiO2与治疗前比较,均有显著性差异(P均<0.05)。结论对急性心源性肺水肿患者应用无创双水平气道正压(Bi-PAP)通气能迅速改善低氧血症和心功能,有效缓解症状,是抢救急性心源性肺水肿一种安全有效的治疗方法。

Objective To asses the efficacy of non-invasive bi-level positive pressure ventilationin the treatment of acute cardiogenic pulmonary edema. Methods Twenty-five patients with acute cardiogenic pulmonary edema were treated with non-invasive Bi-level positive pressure ventilation in addition to conventional treatment.Before and after treatment the changes of symptoms andrelated parameters,such as blood pressure,heart rate,respiration rate and arterial blood gas were measured. Results After BiPAP ventilation,the symptoms of 20 patients were improved significantly.Also,the clinical parameters,including blood pressure,heart rate,respiration rate,blood gas（PH,PaCO2,SaO2） and PaO2/FiO2,showed significant differences compared with those be-fore treatment（P0.05）.Therefore,endotracheal intubation could be avoided. Conclusions Non-invasive BiPAP mask ventilation could improve symptoms and hypoxemia in patients with acute cardiogenic pulmonary edema.It is a safe and effective method for treating acute pulmonary edema.