无创正压通气在老年急性心肌梗死并发急性肺水肿中的应用

目的探讨无创正压通气治疗老年急性心肌梗死并发急性肺水肿的疗效。方法55例老年急性心肌梗死并发急性肺水肿患者，在常规治疗无效的基础上采用双水平气道内正压通气（BiPAP）ST-D-30呼吸机经鼻罩双向正压通气治疗。观察治疗前后患者血气分析、血压、心率和呼吸频率的变化。结果给予经鼻罩BiPAP治疗后50例患者呼吸频率、心率、血压、血气分析等指标有明显改善（P〈0．01），5例无效改为气管插管，BiPAP治疗总有效率为．91％。结论BiPAP鼻罩式双向正压机械通气可迅速改善老年急性心肌梗死患者的心功能，并更快改善肺水肿和低氧血症。

Application of noninvasive positive-pressure respiration for elderly patients with acute myocardial infarction complicated with acute pulmonary edema

Objective To investigate the effects of noninvasive positive-pressure respiration for aged patients with acute myocardial infarction complicated with acute pulmonary edema. Methods Fifty-five aged patients with acute myocardial infarction complicated with acute pulmonary edema received BiPAP ST-D-30 mechanical ventilation treatment when the conservative treatment was not effective. Before and after treatment, the blood gas index, blood pressure, heart rate and respiration rate were recorded. Results Respiration rate, heart rate, blood pressure and the blood gas index of 50 aged patients were found to be significantly improved after using BiPAP ventilation by nasal mask（ P 〈 0.01 ）. Five patients underwent tracheal intubation after the symptom deteriorated. The efficiency rate of BiPAP ventilation was 91%. Conclusions BiPAP mechanical ventilation can more rapidly improve cardiac function, pulmonary edema and hypoxemia for aged patients with acute myocardial infarction.