BiPAP无创通气在急性心源性肺水肿救治中的应用

目的 探讨双水平正压无创机械通气在救治急性心源性肺水肿患者中的疗效.方法 将我科收治的59例急性心源性肺水肿患者随机分为两组:在常规利尿、扩血管、强心和镇静治疗的基础上,治疗组26例经BiPAP无创通气治疗;而对照组33例则给予高浓度面罩吸氧,观察两组治疗前后心率、呼吸频率、血气分析指标及临床征象的变化,评价治疗效果.结果 治疗组无创正压通气2 h后患者心率(HR)、呼吸频率(RR)明显减慢(P＜0.05),收缩压(ABP)及舒张压(DBP)明显下降(P＜0.01),血氧饱和度(SaO2)明显升高(P＜0.01).结论 BiPAP无创通气治疗急性心源性肺水肿起效快,能明显改善低氧血症,是抢救急性心源性肺水肿的重要方法之一,值得临床推广.

The treatment application of acute cardiogenic pulmonary edema with BiPAP noninvasive positive air pressure ventilation

Objective To evaluate the effects of BiPAP noninvasive positive air pressure ventilation on acute cardiogenic pulmonary edema.Methods Fifty-nine patients with acute cardiogenic pulmonary edema were randomly divided into two groups: 26 patients in treatment group received BiPAP,while 33 patients in control groups had high concentration oxygen mask.All the patients received conventional treatments including diuresis,cardiac stimulant,and sedation.Results Two hours after BiPAP,the patients′ heart rate and breathing rate slowed down obviously(P<0.05),and their systolic pressure and diastolic pressure declined clearly(P<0.01).Besides,the oxygen saturation of blood rose obviously(P<0.01).Conclusion BiPAP noninvasive positive air pressure ventilation can improve meionectic blood better and take into effect quickly.Therefore it is an important means to rescue acute pulmonary edema and worth to popularize.