BiPAP无创机械通气治疗急性心源性肺水肿的临床研究.DOCVIP

临床医学论文-BiPAP无创机械通气治疗急性心源性肺水肿的临床研究 【摘要】 目的 评价BiPAP无创机械通气治疗急性心源性肺水肿病例的疗效。方法 对我院收治的急性心源性肺水肿随机分为两组，治疗组25例急性心源性肺水肿患者在传统常规治疗同时加用BiPAP呼吸机经鼻（面）罩双水平气道正压通气治疗，对照组23例在传统常规治疗上加用鼻导管给氧治疗。结果 BiPAP组通气治疗后，23例患者临床症状明显改善，血气分析中pH、PaO2、PaCO2、SaO2等参数比较差异有显著性（P0.05)，总有效率为92.0%，避免了气管插管机械通气。对照组总有效率为73.9%。结论 BiPAP无创机械通气治疗急性心源性肺水肿能迅速纠正缺氧、改善心功能。可作为抢救急性心源性肺水肿的一种安全、有效的方法。 ??? 【关键词】 BiPAP；急性；心源性肺水肿；无创机械通气 ???? Clinical study of noninvasive mechanical bi-level positive airway pressure(BiPAP) ventilation in the treatment of acute cardiogenic pulmonary edema ??? 【Abstract】 Objective To asses the efficacy of noninvasive nasal (facial) mask bi-level positive airway pressure (BiPAP) ventilation in acute cardiogenic pulmonary edema.Methods Dividing all the patients with acute cardiogenic pulmonary edema admitted in our hospital into 2 groups stochastically:treatment group and control group.25 patients in the treatment group were treated with noninvasive nasal (facial) mask bi-level positive airway pressure (BiPAP) ventilation in addition to conventional treatment.23 patients in the control group were treated by nasal pipe with oxygen in addition to conventional treatment.Results After BiPAP ventilation,the clinical symptoms of 23 patients in the treatment group had been improved significantly.Also,the clinical symptoms and arterial blood gas parameters (pH、PaO2、PaCO2、SaO2)showed a statistical differences (P0.05) compared with those before BiPAP mask ventilation.The total efficiency rate of BiPAP group was 92.0%,while that of control group was only 73.9%.Therefore,endotracheal intubation could be avoided.Conclusion Noninvasive BiPAP mask ventilation could improve hypoxemia and cardiac function in patients with acute cardiogenic pulmonary edema.It is a safe and effective method in treating acute cardiogenic pulmonary edema. ??? 【Key words】 BiPAP;acute;cardiogenic pulmonary edema;noninvasive mechanical ventilation ??? 急性心源性肺水肿（acute cardiogenic pulmonary edema,ACPE)是临床常见急症。近年来，随着心血管疾病的增多，急性心源性肺水肿发病率显著升高。而对