双水平气道正压无创通气治疗急性心源性肺水肿的临床观察

目的探讨在重症监护病房中双水平正压（BiPAP）无创通气治疗急性心源性肺水肿的疗效。方法将80例急性心源性肺水肿患者随机分成两组：对照组40例，给予常规治疗（吸氧、镇静、强心、利尿、血管扩张药、激素、解痉平喘等）；治疗组40例，在常规治疗的基础上，加用无创正压通气治疗，观察两纽患者治疗前后临床症状、体征和动脉血气分析的变化。结果治疗组进行无创机械通气后，37例患者在2h内症状好转，呼吸减慢，心率下降，肺部湿哆音减少，动脉氧分压（PaCO2）上升，动脉二氧化碳分压（PaCO2）下降，总有效率为92．5％；对照组在相应时间仅23例好转，有效率为57．5％；两组相比差异有统计学意义（P〈0．05）。结论在发生急性心源性肺水肿时，双水平正压无创通气治疗安全，效果显著。

Clinical observation of BiPAP noninvasive ventilation in the treatment of acute cardiogenic pulmo- Mary edema

Objective To investigate the clinical value of Bi - level positive airway pressure（ Bi- PAP） noninvasive ventilation on acute cardiogenic pulmonary edema. Methods Eighty patients with acute cardiogenic pulmonary edema were randomly divided into two groups： treatment group and control group. Forty patients in the treatment group were treated with noninvasive mask Bi -level positive airway pressure （BiPAP） ventilation in addition to conventional treatment. Forty patients in the control group were treated by nasal pipe with oxygen in addition to conventional treatment. Patients were observed before and after the clinical symptoms, signs and arterial blood gas analysis. Results After BiPAP ventilation, the clinical symptoms of 37 patients in the treatment group had been improved significantly in two hours. Also, the clinical symptoms and arterial blood gas parameters （ pH, PaO2, PaCO2, SaO2 ） showed a statisti- cal differences （ P 〈 0.05 ） compared with control group. The total efficiency rate of treatment group was 92.5% ,while that of control group was only 57.5%. Conclusions Bi - level positive airway pressure therapy is effictive and safe in acute pulmonary edema.