双水平气道正压对老年急性心源性肺水肿合并呼吸衰竭的疗效观察

目的通过监测双水平气道正压(BiPAP)无创通气对老年急性心源性肺水肿病人的影响,从而评估其临床推广使用的安全性。方法回顾性分析54例常规治疗效果不佳的老年急性心源性肺水肿病人,及时使用BiPAP无创通气并观察治疗效果和血流动力学参数[心率(HR)、平均动脉压(MBP)、中心静脉压(CVP)]、血气[氧合指数(OI)、碳酸氢根离子(HCO3-)]的变化。结果及时使用BiPAP后,患者血流动力学指标(HR)明显缓解(P<0.01);血气分析的数值(OI,HCO3-)明显改善(P<0.05);并且对多巴胺的依赖明显降低(P<0.01);总的治疗有效率高达87%。结论早期使用BiPAP无创通气对老年急性心源性肺水肿合并呼吸衰竭病人具有良好的效果。

Effects of BiPAP ventilation on elderly patients with acute pulmonary edema complicated with respiratory failure

Objective To observe the therapeutic effects of bilevel positive air pressure (BiPAP) ventilation on elderly patients with acute pulmonary edema complicated with respiratory failure. Methods The clinical data of 54 elderly patients with acute pulmonary edema treated by BiPAP ventilation were reviewed and analyzed. During the BiPAP ventilation, the efficiency rate and the changes of arterial blood gas(OI, HCO-3) were measured. The hemodynamic parameters(HR,MBP, CVP) were detected. Results The patients receiving BiPAP ventilation showed more significant improvement of the efficiency rate (87%) and the hemodynamic parameters (HR) was decreased obviously(P<0.01) during non-invasive ventilation. The levels of arterial blood gas (OI, HCO-3) were improved significantly, and the dose of dopamine was also decreased obviously(P<0.05 or P<0.01). Conclusions The BiPAP ventilation is safe for elderly patients with acute pulmonary edema.