经鼻(面)罩双水平气道正压通气治疗急性肺水肿的护理研究

目的评价无创性鼻(面)罩双水平气道正压(BiPAP)通气治疗急性肺水肿的疗效。方法对20例急性肺水肿(心源性和非心源性)患者在传统常规治疗同时加用BiPAP呼吸机经鼻(面)罩双水平气道正压通气治疗，观察通气前后动脉血气分析中pH,PaO2、PaCO2、SaO2的变化，患者HR、RR、SBP、DBP及临床征象的变化。结果通气治疗后，20例患者临床症状明显改善，血气分析pH、PaO2、PaCO2、SaO2等参数比较有显著性差异(P<0.05)，避免了气管插管机械通气。结论应用无创性BiPAP鼻(面)罩通气治疗急性肺水肿，只要我们能够熟练掌握各种护理操作，确保患者有效地通气就能够迅速改善患者症状和低氧血症，避免机械通气，无创性BiPAP通气是抢救急性肺水肿的一种安全有效的方法。

Nursing Study on Nasal/facial Mask Bi-level Positive Airway Pre ssure Ventilation

Objective\ To asses the efficacy of nasal (facial) mask positive airway pressure (BiPAP) ventilation in acute pulmonary edema.Methods\ 20 Patients with acute pulmonary edema (cardiogenic and non cardiogenic) were treated with nasal (facial) mask positive pressure (BiPAP) ventilation in addition to conventional treatment.The changes of clinical symptoms and arterial blood gas (pH,PaCO 2,PaO 2 and SaO 2) were measured to evaluate the efficacy of BiPAP mask ventilation.Results\ After BiPAP ventilation,the clinical symptoms of all patients had been improved significantly.Also,the clinical parameters showed a statistical differences (P<0.05) compared with those before BiPAP mask ventilation.Conclusion\ Endotracheal intubation or tracheotomy could be avoided for the patient with acute pulmonary edema by using noninvasive BiPAP mask ventilation,it reduces the pain and complications of the patient,shorts the time of being in hospital,lightens the patient's economical burden.Through the perfect nursing in the clinical use of BiPAP ventilation,it can improve the symptoms and hypoxemia of the patient by ehsuring efficient ventilation.We think that BiPAP ventilation is safe and effective methods for extending use in clinic.