人工机械通气在急性致死性肺水肿抢救中的作用

目的：探讨人工机械通气救治急性重症肺水肿的疗效。方法：对38例急性重症肺水肿(心源性和非心源性)患者在传统常规治疗同时加用人工机械通气辅助呼吸，呼吸机经鼻、口插管或气管切开进行气道正压通气治疗，观察通气前后动脉血气中pH、PaO2、PaCO2、SaO2的变化以及患者心率(HR)、呼吸频率(RR)、血压(BP)和临床征象的变化。结果：通气治疗后，35例患者临床症状明显改善，pH、PaO2、PaCO2、SaO2等参数与治疗前比较有显著性差异(P＜0．01)，顺利脱机。抢救成功率为92．1％，死亡3例，死亡率7．9％。结论：人工机械通气治疗急性重症肺水肿，能迅速改善患者症状和低纸血症，是抢救急性重症肺水肿的一种安全有效的辅助治疗方法。

Effect of artificial controlled mechanical ventilation on the treatment of patients with acute life-threatening pulmonary edema

Objective To investigate the efficacy of artificial controlled mechanical ventilation on the treatment of patients with acute life-threatening pulmonary edema. Methods 38 patients with acute severe pulmonary edema (cardiogenic and non-cardiogenic)were treated with artificial controlled mechanical ventilation in addition to conventional treatment. The changes of clinical sympoms, arterial blood gas (pH, PaO 2, PaCO 2, SaO 2),HR,RR and BP were measured to evaluate the efficacy of artificial controlled mechanical ventilation Results After controlled mechanical treatments, the clinical symptoms of 35 patients had been improved significantly. All the clinical parameters showed a statistical differences ( P <0.01) compared with those before controlled mechanical ventilation. 35 patients successfully received and the rate of success in treatment were 92.1%.3 patients were failure and the mortality were 7.9%. Conclusion Artificial controlled mechanical ventilation could improve symptoms and hypoxemia in patients with acute severe pulmonary edema. It was a safe and effective method in treating acute severe pulmonary edema.