无创压力支持通气与持续气道正压通气对急性心源性肺水肿患者疗效的比较

Comparing the effect of non-invasive pressure support ventilation and continuous positive airway pressure in cardiogenic pulmonary edema obstructive patients

目的:比较无创压力支持通气(NIPSV)与持续气道正压通气(CPAP)两种模式对急性心源性肺水肿患者的治疗效果。方法:采用前瞻性对照研究的方法将123例急性心源性肺水肿随机分为NIPSV组(69例)及CPAP组(54例),比较2组患者住院期间的病死率、气管插管率及机械通气时间等指标。结果:2组患者病死率和插管率差异均无统计学意义(P>0.05)。NIPSV组患者机械通气时间明显短于CPAP组(P<0.01)。CPAP组伴有高碳酸血症患者病死率高于NIPSV组(P<0.05)。结论:NIPSV与CPAP在降低病死率与插管率方面的效果相当,急性心源性肺水肿患者伴有二氧化碳增高时采用NIPSV治疗效果要优于CPAP。

Objective： To compare the role of non-invasive pressure support ventilation （NIPSV） and continuous positive airway pressure（CPAP） in cardiogenic pulmonary edema obstructive patients. Methods： A prospective, randomized, controlled study was performed in an emergency departments, 123 patients were assigned to CPAP （ n = 54 ） and NIPSV （ n = 69 ） groups. The mortality, tracheal intubation rate and mechanical ventilation time were compared. Results：There were no significant difference about the mortality and intubation rate between the two groups（P 〉 0.05）. The mechanical ventilation time in NIPSV group was significantly shorter than that in CPAP group （ P 〈 0.01 ）. The mortality was higher in CPAP group with hypercarbia than that in NIPSV group （ P 〈 0.05 ）. Conclusions：The mortality and rate of reintubation of CPAP and NIPSV was similar in the mortality and intubation rat. When the cardiogenic pulmonary edema obstructive patients were accompanied with hypercarbia, NIPSV was more effective than CPAP.