经鼻面罩持续气道正压治疗重症心源性肺水肿的疗效观察

Treatment of Severe Cardiogenic Pulmonary Edema with Continuous Positive Airway Pressure by Nasal Face Mask

目的 :为了评价经鼻面罩持续气道正压 (CPAP)对心源性肺水肿急性发作的疗效。方法 :5 1例病人随机分为两组 :治疗组 2 5例 ,吸氧浓度为 45 %加用CPAP ;对照组 2 6例 ,单用吸氧 6L/min。结果 :CPAP治疗 30min后PaO2 (P <0 .0 0 5 )明显升高 ,而呼吸频率和心率明显降低 (P <0 .0 5 ,P <0 .0 5 ) ;治疗 12h后 ,显效率为 5 2 % (13/2 5 ) ,总有效率为 88% (2 2 / 2 5 ) ,明显高于对照组 (P <0 .0 1、P <0 .0 5 )。结论 :CPAP能明显提高PaO2 ,显著改善心源性肺水肿病人的心肺功能 。

Objective:To assess the effect of continuous positive airway pressure (CPAP) by nasal face mask on the patient with cardiogenic pulmonary edema during acute episodes of the disease. Methods:51 patients with severe cardiogenic pulmonary edema were studied. Among them, 26 received oxygen alone at a flow yate of 6 liters perminutes(control group)and 25 received 45% oxygen plus CPAP by nasal face mask connecting ventilator(CPAP group).Results:PaO 2 in the CPAP was significantly increased (P&lt;0.005), whereas the respiratory rate and heart rate were significantly decreased(P&lt;0.05,P&lt;0.05) after 30 minutes. Conclusion:The CPAP could significantly improve physiologic cardiovascular and pulmonary and significantly reduce the need for intubation and mechanical ventilation in the patients with severe cardiogenic pulmonary edema.