无创正压通气对妊娠合并肺水肿的疗效及胎儿的影响评价  

NIPPV:clinical therapeutic effection in pregnant women with pulmonary edema and influence on fetus

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作  者:童武华[1] 

机构地区:[1]嘉兴市妇幼保健院ICU,324050

出  处:《国际呼吸杂志》2013年第10期772-774,共3页International Journal of Respiration

摘  要:目的评价无创正压通气(NIPPV)在妊娠合并肺水肿时的临床疗效和对胎儿的影响。方法回顾性分析38例妊娠合并肺水肿患者,随机分为非治疗组和治疗组,非治疗组仅给予常规综合治疗,治疗组在常规综合治疗基础上加用NIPPV,监测两组患者治疗前和治疗后30、60、120min的临床症状、体征、血气分析、每分心输出量(C0)和胎监评分,以及胎儿出生后1min的Apgar评分。2h后评定临床疗效。结果与非治疗组相比,治疗组治疗30、60、120min后SaOz、PaO2、PaO2/FiO2、CO、胎监评分、胎儿出生后1min的Apgar评分均增高(P〈0.05),心率、呼吸频率降低(P〈0.05),PaCO2、pH、平均血压则差异无统计学意义(P〉0.05),治疗2h后的临床总有效率和显效率均增高(P〈O.05),治疗组无严重不良反应。结论NIPPV是治疗妊娠合并肺水肿安全、有效的方法,能显著改善胎儿宫内窘迫。Objective To assess the clinical effection of noninvasive positive pressure ventilation (N1PPV) in pregnant women with pulmonary edema and the influence of NIPPV on fetus. Methods 38 pregnant women with pulmonary edema were divided into control group and treatment group. The control group was treated with routine therapy, and the treatment group with routine therapy plus NIPPV. The clinical symptoms, signs, blood gas analysis, minute cardiac output (CO), and fetal monitoring scores were measured before treatment and at 30 min, 60 min, 120 min after treatment. The Apgar scores were measured after birth. The clinical effection was evaluated at 2 h after treatment. Results Compared with control group,SaO2 , PaO2, PaO2/FiO2, CO, fetal monitoring scores at 30 min, 60 min, 120 min after treatment,and Apgar scores were increased in treatment group (P d0.05), heart rate and respiratory rate were decreased ( P d0.05) ,and there was no statistical significance in PaCO2 ,pH,and mean blood pressure between two groups. The total effective rate and the obvious effective rate at 2 h after treatment in treatment group were higher than those in control group. There was no severe adverse reaction in treatment group. Conclusions NIPPV is an effective and safe therapy for pregnant women with pulmonary edema. It can also improve fetal distress markedly.

关 键 词:无创正压通气 妊娠 肺水肿 

分 类 号:R714[医药卫生—妇产科学]

 

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