无创通气治疗急性心源性肺水肿失败的多因素分析

目的分析应用无创通气（NIV）治疗急性心源性肺水肿（ACPE）失败的多种因素。方法65例ACPE患者在应用NIV治疗后根据结果分为NIV成功组和NIV失败组，将两组治疗前的相关因素和治疗时相关指标的变化进行比较，分析NIV治疗失败的预警因素和观察指标。结果27例NIV治疗失败，与成功组比较，NIV失败组年龄偏大、患急性心肌梗死、PaCO2下降、PH增高、MPA低。NIV治疗期间治疗成功组患者HR的改善优于失败组（P〈0、05）。结论NIV治疗前，高龄、急性心肌梗死患者、PaCO2下降、PH增高、MPA低可以作为预警因素；NIV期间观察HR、RR、PaO2、PaCO2可以及时判断NIV治疗的有效性。

Analysis of Multivariate Factors for Noninvasive Ventilation In the Patients with Acute Cardiogenic Pulmona-ry Edema

Objective To analyze the multivariate factors associated with failure of applying noninvasive ven-tilation(NIV)in the patients with acute cardiogenic pulmonary edema(ACPE).Methods 65 patients with ACPE re-ceived NIV treatment,and were divided into NIV syccess group and NIV failure group according to the result with NIV therapy.Compared with the exchanges of the relevant parameters before the treatment and in the treatment between these two groups,analysis the alert factors and observational factors of the failure in NIV treatment.Resylts 27 cases in failure on NIV were elders,with acute myocardial infarction,decline on PaCO_2,raise on PH,low on MPA,compared with the success group.In NIV treatment and observing the changes of RR,PaO2,PaCO_2,there is a obviously differ-ence(P<0.05)on the HR improvement in the patients of the success group compared with the patients of the failure group.Conclusion The factors of elder,acute myocardial infarction,decline on PaCO_2,raise on PH,low on MPA could be seemed as the alert factors before the NIV treatment,the efficiency of therapy of NIV could be judged through observing HR,RR,PaO_2,PaCO_2 in NIV treatment.