无创双水平正压机械通气在急性心源性肺水肿中的应用

目的探讨无创双水平正压机械通气(BNIV)在急性心源性肺水肿(ACPO)中的疗效及其安全性。方法将52例ACPO患者随机分为常规组(27例),BNIV+药物治疗组(BNIV组)25例。观察两组患者病情缓解时间,即开始治疗后0.5、1、2h及3d后心功能分级指标以及住院期间的病死率等。结果BNIV组患者的心功能分级指数在开始治疗后0.5、1、2h及住院期间的病死率明显优于单纯药物治疗组(P<0.05);3d时心功能分级,两组无显著性差异(P>0.05);BNIV组的治疗成功率在0.5、1、2h明显优于常规组(P<0.05);而3d后的成功率在两组之间无显著性差异。结论BNIV在辅助药物治疗ACPO中可明显加快病情的改善,提高早期治疗成功率,降低住院期间的病死率。

Application of bilevel non-invasive ventilation in the treatment of acute cardiogenic pulmonary edema.

Objective To study the safety and effect of bilevel non-invasive ventilation(BNIV) in the treatment of acute cardiogenic pulmonary edema(ACPO).Methods 52 ACPO cases were randomly divided into routine medication group(n=27) and BNIV+medication group(BNIV group,n=25).NYHA grades at 0.5 h,1 h,2 h and 3 days after treatment and hospitalization mortality rate were observed in both group.Results NYHA grades at 0.5 h,1 h and 2 h after treatment and the hospitalization mortality in BNIV+medication group were superior to medication group~(P<0.05) ;but no difference was found between two groups after 3 days(P>0.05).The success rate in BNIV+medication group at 0.5 h,1 h and 2 h was significantly superior to medication group(P<0.05) but no difference in success rate was found between two groups after 3 days.Conclusion ACPO treated by BNIV+medication can improve the disease,increase the early success rate and decrease the hospitalization mortality.