早期双水平正压通气治疗老年急性心源性肺水肿的临床分析  

Clinical study on early application of bi-level positive airway pressure ventilation in the treatment for acute cardiogenic pulmonary edema in the elderly

作　　者：任天成[1] 侯传勇[1] 葛卫星[1] 张明[1] 许平[1] 魏芳玲[1] 魏飞[1] 

机构地区：[1]南京医科大学附属江宁医院急诊医学科,江苏省南京市211100

出　　处：《实用老年医学》2013年第11期936-938,共3页Practical Geriatrics

摘　　要：目的探讨早期应用双水平正压通气(BiPAP)治疗老年急性心源性肺水肿(ACPE)的临床效果。方法 50例老年ACPE患者分为早期BiPAP组和常规治疗组(对照组),每组各25例。早期BiPAP组在常规治疗的同时即给予BiPAP治疗,对照组给予吸氧、吗啡、利尿剂、血管扩张剂、洋地黄类强心剂、氨茶碱等常规治疗。比较2组治疗2、4 h后各项生理参数、动脉血气、气管插管率和住院率的变化。结果与对照组比较,BiPAP组治疗后的心率、呼吸频率明显下降(P<0.05),动脉血气和动脉血氧饱和度改善明显(P<0.05),气管插管率和住院率明显下降(P<0.05)。结论在急诊科早期应用BiPAP可迅速改善老年ACPE患者的生理参数和动脉血气指标,缓解呼吸困难症状,安全、有效,具有较好临床价值。Objective To explore the effects of early application of bi-level positive airway pressure( BiPAP) ventilation on elderly patients with acute cardiogenic pulmonary edema( ACPE) in Department of Emergency. Methods Fifty elderly patients with ACPE were divided into two groups with 25 patients in each. The patients in control group received routine treament,including oxygen,morphine,diuretics,vasodilators,digitalis and aminophylline. The patients in BiPAP ventilation group received BiPAP ventilation in the early stage on the basis of routine treatment. Physiological parameters, arterial blood gas and endotracheal intubation rate and hospitalization rate at admission and 2,4 hours after therapy were measured and compared between the two groups. Results Compared to the control group,the respiratory rate and heart rate were significantly decreased( P < 0. 05),and the arterial oxygen saturation and the parameters of arterial blood gas were significantly improved( P < 0. 05),and the endotracheal intubation and hospitalization rate were significantly reduced( P <0. 05) in BiPAP ventilation group after therapy. Conclusions Early application of BiPAP ventilation can regulate the physiological parameter and arterial blood gas,and alleviate the symptom of dyspnea. It is proved to be valuable and safe for the treament of elderly patients with ACPE in Department of Emergency.

关 键 词：急性心源性肺水肿 双水平正压通气 动脉血气分析 

分 类 号：R541.63[医药卫生—心血管疾病]