无创正压通气救治急性心源性肺水肿的疗效观察

Curative effect observation of noninvasive positive pressure ventilation in the treatment of acute cardiogenic pulmonary edema

目的探讨无创正压通气(NPPV)治疗急性心源性肺水肿(ACPE)的效果。方法将38例急性心源性肺水肿患者随机分为对照组和NPPV组,其中对照组19例,采用常规治疗;NPPV组19例,在常规治疗的基础上给予其无创正压通气。观察并比较两组患者治疗前后的心率(HR)、呼吸频率(RR)、血压(BP)、动脉血气分析(PH、PaO2、PaCO2)及治疗效果。结果两组治疗后的HR、BP、RR、PH、PaO2均明显改善;NPPV组通气治疗后1、3 h的BP、PaO2及治疗后1 h的PH、RR较对照组改善更明显(P<0.05),且NPPV组的有效率高于对照组(P<0.05)。结论无创正压通气治疗急性心源性肺水肿较常规治疗能迅速纠正缺氧及改善心肺功能,疗效肯定。

Objective To discuss the effect of noninvasive positive pressure ventilation （NPPV） in the treatment of acute cardiogenic pulmonary edema （ACPE）. Methods 38 patients with ACPE were evenly and randomly divided into the control group and the NPPV group.In the control group,the conventional therapy was provided,while in the NPPV group,on the basis treatment of the control group,NPPV was added.The heart rate （HR）,respiratory rate （RR）,blood pressure （BP）,arterial blood gas analysis including PH,PaO2,and PaCO2,and curative effect before and after treatment were observed and compared. Results After treatment,HR, BP, RR,PH,and PaO2 were all improved in both groups.In the NPPV group,BP and PaO2 after I hour and 3 hours treatment,and PH and RR afterl hour theratment were improved more remarkably than those in the control group （P〈0.05）.The effective rate in the NPPV group was higher than that in the control group （P〈0.05）. Conclusion In comparison with conventional therapy,NPPV treating ACPE can promptly correct anoxia and improve cardio-pulmonary function,which obtains a definite effect.