呼气末正压通气治疗难治性急性肺水肿的临床研究

对31例经常规治疗无效的急性肺水肿（心源性和非心源性）患者，经口或鼻气管插管后给予PEEP通气治疗，PEEP压力一般为5－10mmH2O。观察通气前后动脉血气分析中pH、PaO2、PaCO2、SaO2 的变化，并观察HR、RR、MAP及临床症状的变化。结果：经PEEP通气治疗后，31例患者临床症状均有明显改善，动脉血气分析中pH、PaO2、PaCO2、SaO2治疗前后有显著性差异（P＜0．05），对MAP无明显影响（P＞0．05）；2例神经源性肺水肿（NPE）患者最终死于多脏器功能衰竭（MOF）。认为应用适当PEEP通气治疗难治性肺水肿，能迅速改善患者症状和低氧血症，是抢救难治性急性肺水肿的有效方法。

Clinical sutdy of positive end-expiratory pressure ventilation in the treatment of severe acute pulmonary edema

To evaluate the clinical application of PEEP ventilation in the treatment of severe acute pulmonary edema,31 patients with severe acute pulmonary edema were treated with PEEP ventilation,PEEP pressure 5~10cmH 2O The changes of clinical symptoms,HR RR MAP and arterial blood gas (pH,PaO 2,PaCO 2,SaO 2)were measured to evaluate the efficacy of PEEP ventilation The results showed after PEEP ventilation, the clinical symptoms of all patients has been improved significantly, arterial blood gas (pH,PaO 2,PaCO 2,SaO 2) showed a statistical differences (P<0 05), MAP was not change (P>0 05) But 2 patients of NPE died of MOF These suggest PEEP ventilation could improve symptoms and hypoxemia in patients with severe acute pulmonary edema, it is a effective method in treating severe acute pulmonary edema