双水平正压通气模式在神经源性肺水肿患者中的应用及护理

目的探讨神经源性肺水肿时双水平正压通气（BiPAP）的疗效和护理方法。方法选择2004年1月-2007年12月收治的11例神经源性肺水肿患者，呼吸支持采用Puritan—Bennett840呼吸机特有的有创性BiPAP模式，在该模式下使用气道压力释放通气（APRV）策略。分别比较观察同步间歇强制通气（SIMV）模式、BiPAP模式治疗后2h、BiPAP模式治疗后24h的血氧饱和度（SpO2）、酸碱度值（pH）、动脉氧分压（PaO2）、动脉二氧化碳分压（PaCO2）。结果机械通气由SIMV模式调整为Bi—PAP模式后，11例患者的血气分析SpO2和PaO2明显改善（P＜0．05），未见明显并发症。结论BiPAP模式下压力支持通气是治疗神经源性肺水肿快速和有效的方法。

Clinical application and nursing methods of bilevel positive air way pressure ventilation in patients with neurogenic pulmonary edema

Objective To investigate the clinical effect and nursing methods of bilevel positive airway pressure（BiPAP） ventilation in patients with neurogenic pulmonary edema（NPE）. Methods Totally 11 NPE patients from January 2004 to December 2007 were enrolled. Ventilation support adopted specific invasive BiPAP mode of Puritan-Bennett840. Aiway pressure release ventilation （APRV） tactics was applied in this mode. The blood oxygen saturation rate（SpO2）, acidity-alkalinity（pH）, arterial oxygen pressure （PaO2）, arterial carbon dioxide pressure （PaCO2） were analyzed and compared between synchronized intemittent mandatory ventilation（SIMV） mode,2 h and 24 h after BiPAP ventilation. Results Among arterial blood gas analysis of 11 patients, SpO2 and PaO2 were obviously ameliorated after BiPAP ventilation compared with StMV ventilation. No side-effect occurred. Conclusions The application of invasive BiPAP ventilation support in NPE patients proved to be a fast and effective method.