人工机械通气治疗急性重症心源性肺水肿疗效观察  

Observation on the effect of artificial controlled mechanical ventilation in the treatment of acute severe cardiogenic pulmonary edema

作　　者：祁必富[1] 杨卫泽[1] 魏婕[1] 李文强[1] 万曦[1] 杨河欣[1] 

机构地区：[1]武汉大学人民医院急诊科,武汉430060

出　　处：《临床急诊杂志》2010年第6期330-331,共2页Journal of Clinical Emergency

摘　　要：目的:观察人工机械通气救治急性重症心源性肺水肿的临床效果。方法:对23例重症心源性肺水肿并发急性呼吸衰竭者行气管插管机械通气,观察临床症状及通气前后动脉血气参数、血压、心率、呼吸的改变。结果:22例患者抢救成功,1例患者死亡。与通气前相比,通气治疗2h后,患者临床症状明显好转,心率下降[(135±49)次·min-1/(106±23)次·min-1,P<0.05];呼吸由浅慢变为规则[(7.3±2.4)次·min-1/(21.5±8.9)次·min-1,P<0.01];SaO2和PaO2上升[(52±16)%/(95±14)%,P<0.01;(37.8±12.6)mmHg/(78.9±23.5)mmHg,P<0.01],pH值变为正常[(7.11±0.11)/(97.36±0.07),P<0.05]。结论:人工机械通气治疗急性重症心源性肺水肿,能迅速缓解患者症状,纠正低氧血症,抢救效果良好。Objective：To observe the clinical effect of artificial controlled mechanical ventilation on the treatment of patients with acute severe cardiogenic pulmonary edema.Method：Twenty-three patients with acute severe cardiogenic pulmonary edema were treated with artificial controlled mechanical ventilation,observed the change of arterial blood gas parameters,blood pressure,heart rate,breathe rate and clinical symptoms.Result：Two hours af-ter artificial controlled mechanical ventilation,the clinical symptoms of patients were improved significantly,heart rate decreased[（135±49）times·min-1/（106±23）times·min-1,P0.05];breathe rate became regular[（7.3 ±2.4）times·min-1/（21.5±8.9）times·min-1,P0.01];SaO2and PaO2were improved[（52±16）%/（95 ±14）%,P0.01;（37.8±12.6）mmHg/（78.9±23.5）mmHg,P0.01],pH became normal[（7.11±0.11） /（7.36±0.07）,P0.05].Twety-two patients were rescued,1died.Conclusion：artificial controlled mechanical ventilation could improve symptoms and hypoxemia in the patients with acute severe cardiogenic pulmonary edema. It is an effective method of acute severe cardiogenic pulmonary edema treatment.

关 键 词：机械通气 肺水肿 心源性 

分 类 号：R563.3[医药卫生—呼吸系统]