经鼻（面）罩双水平气道正压通气治疗急性肺水肿的临床疗效分析

目的探讨无创性鼻(面)罩双水平气道正压通气(BiPAP)治疗急性肺水肿的疗效。方法对25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,观察通气前后呼吸频率(RR)、心率(HR)、脉搏血氧饱和度(SaO2)、氧分压(PaO2)及二氧化碳(PaCO2)、收缩压(SBP)和舒张压(DBP)的变化及临床症状的改善情况。结果通气治疗后,25例患者临床症状明显改善,呼吸频率减慢、心率减慢、血压明显下降、氧饱和度上升,低氧血症明显改善(P<0.01),避免了气管插管机械通气。结论应用无创性BiPAP鼻(面)罩治疗急性肺水肿,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。

Clinical Therapeutic Effect of Nasal/Facial Mask Bi-level Positive Airway Pressure Ventilation in Patients with Acute Pulmonary Edema

Objective To investigate the efficacy of nasal(facial)mask bi-level positive airway pressure(BiPAP)ventilation in patients with acute pulmonary edema. Methods Twenty-five patients with acute pulmonary edema either cardiogenic and non-cardiogenic were treated with nasal(facial) mask bi-level positive airway pressure(BiPAP)ventilation in addition to conventional treatment. Clinical symptoms, arterial blood gas(PaCO_2 PaO_2 and SaO_2), respiratory rate and heart rate, systolic and diastolic blood pressure were monitored to assess the efficacy of BiPAP mask ventilation. Results After applied BiPAP ventilation ,the clinical symptoms of all patients were improved significantly. In addition, clinical parameters showed significant improvement (P<0.01) as compared with the same patients before received BiPAP mask ventilation. Conclusion Endotracheal intubation or tracheotomy could be avoided in patients with acute pulmonary edema by using the noninvasive BiPAP mask ventilation,BiPAP ventilation can evidently improve the symptoms and hypoxemia of the patient. BiPAP ventilation is safe and effective methods for salvaging acute pulmonany edema and can be extending its use in clinics.