无创呼吸机治疗急性心源性肺水肿的效果及对肺功能的影响

Effect of noninvasive ventilator in the treatment of acute cardiogenic pulmonary edema and its influence on pulmonary function

目的探讨无创呼吸机治疗急性心源性肺水肿(ACPE)的效果及对肺功能的影响。方法选取2019年1月至2021年6月我院收治的80例ACPE患者为研究对象,依据入院编号的奇偶性将其分为对照组与观察组,各40例。对照组给予面罩高流量吸氧支持治疗,观察组采用无创呼吸机行无创正压通气(NIPPV)治疗。比较两组的治疗效果。结果治疗30 min、1、4、8、12 h后,观察组的呼吸频率(RR)、心率(HR)、肺部超声B线数低于对照组(P<0.05);治疗1、4、8、12 h后,观察组的平均动脉压(MAP)低于对照组(P<0.05);治疗30 min、1、4 h后,观察组的体温(T)低于对照组(P<0.05)。治疗30 min、1、4、8、12 h后,观察组的二氧化碳分压(PaCO_(2))低于对照组,血氧饱和度(SPO_(2))、动脉血氧分压(PaO_(2))高于对照组(P<0.05)。观察组的过度镇静、面部不适、腹胀、呕吐、排痰障碍及呼吸障碍发生率低于对照组(P<0.05)。治疗后,观察组的用力肺活量(FVC)、每分钟最大通气量(MVV)、第1秒用力呼吸容积(FEV1)、呼气峰流速(PEF)及FEV1/FVC均高于对照组(P<0.05)。结论无创呼吸机治疗ACPE的效果较好,其可快速恢复生命体征相关指标,改善血气指标,促进肺功能恢复,减少不良事件。

Objective To investigate the effect of noninvasive ventilator in the treatment of acute cardiogenic pulmonary edema(ACPE)and its influence on pulmonary function.Methods A total of 80 patients with ACPE admitted in our hospital from January 2019 to June 2021 were selected as the research objects.According to the parity of admission number,the patients were divided into control group and observation group,with 40 cases in each group.The control group was treated with mask high flow oxygen support,and the observation group was treated with non-invasive positive pressure ventilation(NIPPV)with noninvasive ventilator.The therapeutic effects of the two groups were compared.Results After 30 min,1,4,8 and 12 h of treatment,the respiratory rate(RR),heart rate(HR)and B-line number of lung ultrasound in the observation group were lower than those in the control group(P<0.05);after 1,4,8 and 12 h of treatment,the mean arterial pressure(MAP)of the observation group was lower than that of the control group(P<0.05);after 30 min,1 and 4 h of treatment,the temperature(T)of the observation group was lower than that of the control group(P<0.05).After 30 min,1,4,8 and 12 h of treatment,the partial pressure of carbon dioxide(PaCO_(2))in the observation group was lower than that in the control group,and the pulse oxygen saturation(SPO_(2))and partial pressure of oxygen in arterial blood(PaO_(2))were higher than those in the control group(P<0.05).The incidences of excessive sedation,facial discomfort,abdominal distension,vomiting,expectoration disorder and respiratory disorder in the observation group were lower than those in the control group(P<0.05).After treatment,the forced vital capacity(FVC),minute ventilation volume(MVV),forced expiratory volume in one second(FEV1),peak expiratory flow(PEF)and FEV1/FVC in the observation group were higher than those in the control group(P<0.05).Conclusion Noninvasive ventilator is effective in the treatment of ACPE,it can quickly restore vital signs related indexes,improve blood gas indexes,promote pulmonary function recovery and reduce adverse events.