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双水平气道正压无创通气治疗急性心源性肺水肿患者的临床分析
引用本文:屈健民,;赵云峰. 双水平气道正压无创通气治疗急性心源性肺水肿患者的临床分析[J]. 新医学, 2014, 0(10): 671-674
作者姓名:屈健民,  赵云峰
作者单位:[1]浙江桐乡市第一人民医院ICU,桐乡314500; [2]上海浦东新区公利医院呼吸科,上海200135
摘    要:目的:观察双水平气道正压(BiPAP)无创通气治疗急性心源性肺水肿患者的临床疗效。方法收集85例急性心源性肺水肿患者的治疗情况,其中给予正性肌力药物、利尿药、血管活性药物等常规抗心力衰竭治疗的基础上行 BiPAP 无创通气治疗的50例患者作为治疗组,给予面罩吸氧等常规抗心力衰竭治疗的35例患者为对照组。比较两组的临床疗效。结果与对照组比较,治疗组患者经 BiPAP 无创通气治疗后,患者的临床症状改善更明显,6 h 乳酸清除率及治疗有效率均明显高于对照组(P 均<0.05),气管插管率及病死率均明显低于对照组(P 均<0.05)。结论BiPAP 无创通气能迅速改善急性心源性肺水肿患者的临床症状,降低气管插管率及病死率。

关 键 词:双水平气道正压无创通气  急性心源性肺水肿

Clinical analysis of BiPAP non-invasive ventilation in treatment of patients with acute cardiogenic pul-monary edema
Affiliation:QU Jian-min, ZHAO Yun-feng (Division of lCU, the First Hospital of Tongxiang City, Tongxiang 314500, China)
Abstract:Objective To observe the clinical efficacy of non-invasive bi-level positive airway pres-sure ventilation (BiPAP)in the treatment of patients with acute cardiogenic pulmonary edema.Methods Eighty-five patients with acute cardiogenic pulmonary edema were retrospectively analyzed and assigned into two groups.In the treatment group,fifty cases were treated with BiPAP non-invasive ventilation on the basis of anti-heart failure treatment such as positive inotropic,diuretics and vasoactive drugs.In the control group,35 pa-tients underwent oxygen masks based upon anti-heart failure therapy.The clinical effects in two groups were compared.Results Compared with the control group,the clinical symptoms of the patients,who treated with BiPAP non-invasive ventilation,were significantly improved,and 6-hour lactic acid clearance rate and effective rate were significantly higher (all P 〈0.05),whereas endotracheal intubation rate and mortality were signifi-cantly lower (both P 〈0.05).Conclusion BiPAP can alleviate the symptoms of patients with acute cardio-genic pulmonary edema and reduce endotracheal intubation rate and mortality.
Keywords:BiPAP non-invasive ventilation  Acute cardiogenic pulmonary edema
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