应用双水平正压通气联合呼气末正压治疗神经源性肺水肿46例临床观察

目的探讨应用双水平正压通气（BiPAP）联合呼气末正压（PEEP）通气治疗神经源性肺水肿的疗效。方法对46例神经源性肺水肿患者经过及时采用双水平正压联合呼气末正压通气治疗。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BiPAP模式后，45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联合PEEP支持通气是治疗神经源性肺水肿快速和有效的方法。

Clinical Analysis of Bilevel Positive Air Way Pressure Ventilation Combined with Positive End-expiratory Pressure Ventilation in the Treatment of 46 Cases with Neurogenic Pulmonary Edema

Objective To investigate the effect of bilevel positive air way pressure （BiPAP） ventilation combined with the positive end-expiratory pressure （PEEP） ventilation in the treatment of neurogenic pulmonary edema. Methods 46 patients with neurogenic pulmonary edema were treated with bilevel positive air way pressure ventilation combined with positive end-expiratory pressure ventilation timely. Airway pressure release ventilation （APRV） tactics were applied to this mode. The blood oxygen saturation （SpO2）, potential of hydrogen （pH）, arterial partial pressure of oxygen （PaO2）, arterial partial pressure of carbon dioxide （PaCO2） were analyzed and compared between synchronized intermittent mandatory ventilation（SIMV） mode, 2h and 24h after BiPAP venti- lation. Results Among the arterial blood gas analysis of 46 patients,SpO2 and PaO2 were obviously ameliorated after BiPAP ventila- tion compared with those of SIMV ventilation（P〈0.05）. No side effects occurred. Conclusion Neurogenic pulmonary edema patients treated with BiPAP combined with PEEP ventilation is proved to be a fast and effective method.