无创正压机械通气辅助治疗急性心源性肺水肿的效果

目的评价无创正压机械通气辅助治疗急性心源性肺水肿的疗效。方法选择27例急性心源性肺水肿患者．在高流量吸氧及常规药物治疗不能纠正缺氧时，经面罩给予无创正压通气，观察使用无创正压机械通气治疗前、治疗后其临床症状、心率、呼吸、血氧饱和度和动脉血气分析的变化。结果经面罩无创正压通气治疗后，27例患者中20例（74．07％）临床症状、体征明显改善，血气分析中氧气分压明显升高，与通气前比较，差异有统计学意义（90．08±15．39）mmHg＇US．（53．12±17．65）mmHg，P〈0．05]；二氧化碳分压下降，与通气前比较，差异有统计学意义（14．52±20．52）mmHgVS．（55．47±23．82）mmHg，P〈0．05]。7例（25．93％）经无创正压通气治疗无效，改为经口气管插管机械通气，2例死亡。结论应用无创正压通气可明显改善急性心源性肺水肿患者的症状、体征和血气分析结果，可作为急性心源性肺水肿安全、快速、有效的辅助治疗手段之一。

Effect of adjuvant treatment of noninvasive positive pressure ventilation in patients with acute cardiogenic pulmonary edema

Objectives To evaluate the effect of adjuvant treatment of noninvasive positive pressure ventilation in patients with acute cardiogenic pulmonary edema.Methods Twenty seven patients with acute cardiogenic pulmonary edema were given noninvasive positive pressure ventilation via face mask after hypoxia cannot be corrected by high-flow oxygen and conventional drug treatment.Clinical symptom,heart rate,breathing,arterial oxygen saturation and changes of arterial blood gas analysis were observed before and after the use of noninvasive positive pressure ventilation.Results Clinical symptoms and signs were obviously improved,oxygen partial pressure significantly increased (90.08±15.39) mm Hg vs.(53.12±17.65) mm Hg,P<0.05],partial pressure of carbon dioxide significantly declined (14.52±20.52) mm Hg vs.(55.47±23.82) mm Hg,P<0.05] in 20 cases(74.07%) out of the 27 patients with acute cardiogenic pulmonary edema after application of noninvasive positive pressure ventilation via face mask.Seven(25.93%) cases treated by orotracheal intubation and mechanical ventilation when noninvasive positive pressure ventilation failed.There were 2 dead cases.Conclusions Application of noninvasive positive pressure ventilation can significantly improve symptoms,signs and blood gas analysis results in patients with acute cardiogenic pulmonary edema.It can be used as one of the safe,rapid and effective adjuvant means of treatment on acute cardiogenic pulmonary edema.