评价无创正压通气在治疗急性高原性肺水肿危重患者的意义及呼吸治疗的探讨

目的 :对急性高原性肺水肿危重患者行无创正压通气后的相关临床资料进行分析 ,评价无创正压通气在治疗急性高原性肺水肿危重患者的临床意义及探讨呼吸治疗策略。方法 :分析以无创正压通气治疗 2 0例由内地进入海拔 2 2 0 0m以上高原的急性高原性肺水肿患者与既往 2 0例同类患者的临床资料。结果 :2 0例患者通过无创正压通气后病情迅速好转 ,2例患者出现气胸等并发症 ,经过调整通气压力 ,适当提高吸入氧浓度后气胸等并发症逐步好转。结论 :与非机械通气治疗相比无创正压通气提高了疗效 ,缩短了住院时间 ,两者有显著性差异 (P <0 0 1) ,急性高原肺水肿危重患者进行无创正压通气时应选择最佳的通气压力 ,以避免气胸及纵隔气肿的发生

Treatment and Evaluation of severe HAPE With Non-invasive Positive Pressure Ventilation

Objective:To retrospect the treatment and the effect of the clinical data of severe acute high altitude pulmonary edema (HAPE) patients treated by the non-invasive positive pressure ventilation (NIPPV). Methods:Clinical data were analyzed about 20 HAPE patients who entered to high altitude areas (2 200m) from plain areas undergone NIPPV and 20 similar kinds of patients with HAPE.Results:20 patients were rapidly improved through NIPPV. Complication such as Pneumothorax occured in 2 of 20 cases but it was gradually improved by reasonable adjustment of ventilation pressure and increase in oxygen concentration inhaled. Conclusions: There was a significant difference between NIPPV and IPPV (P<0.01), and compared with IPPV, NIPPV has advantages in raising therapeutic effect of patients and shortening resident time in hospital.But Optimized mechanical ventilate pressure would be available to avoid pneumothorax and mediastinal emphysema.