无创正压通气治疗急性心源性肺水肿伴低氧血症的前瞻研究  

Noninvasive positive pressure ventilation for acute cardiogenic pulmonary edema complicated with severe hypoxemia: a randomized control study

作　　者：潘慧[1] 彭沪[1] 陈艳清[1] 孔铭颢 阮辉辉[1] 

机构地区：[1]同济大学附属第十人民医院急诊科,上海200072

出　　处：《同济大学学报（医学版）》2014年第6期67-70,共4页Journal of Tongji University(Medical Science)

基　　金：国家自然科学基金(81270133)

摘　　要：目的无创正压通气治疗急性心源性肺水肿并发严重低氧血症的呼吸衰竭患者的临床疗效观察。方法对于我院急诊抢救室救治的40例急性心源性肺水肿患者,在诊断明确后,在吸氧与药物治疗的基础上,干预组（20例）给予初始EPAP 4-6 cm H2O及IPAP 6-8 cm H2O的双水平正压通气（BiPAP）,对照组（20例）为吸氧与药物治疗。观察记录治疗1h后患者的重要生理参数的改变,进行统计分析。结果在应用Bi PAP通气1h后,患者的呼吸频率、心率、平均血压、PaO2、PaCO2、pH值改变等都有明显的改善。结论在急性心源性肺水肿患者的治疗中,无创双水平正压通气可以迅速提高患者的氧合,短期疗效优于单纯吸氧与药物治疗。Objective To evaluate the clinical efficacy of non-invasive positive pressure ventilation（ NPPV） for respiratory failure in acute cardiogenic pulmonary edema patients with hypoxemia.Methods Forty patients with acute cardiogenic pulmonary edema in emergency department were recruited and randomized to intervention group（ n = 20） and control group. In addition to drug therapy non-invasive positive airway pressure ventilation（ Bi PAP） with an initial EPAP（ 4-6 cm H2O） and IPAP（ 6-8 cm H2O） were implemented in intervention group,while drug therapy and nasal oxygen inhalation were given in control group. After treatment for 1 h,physiological parameters were collected for statistical analysis. Results After 1 h of Bi PAP ventilation,the respiratory rate,heart rate,mean blood pressure,PaO2,PaCO2,pH value in intervention group were significantly improved than those before treatment and also than those in control group after treatment. Conclusion Non-invasive Bi PAP ventilation combined with standard medication can rapidly improve oxygenation in patients with acute cardiogenic pulmonary edema.

关 键 词：无创双水平正压通气 急性心源性肺水肿 低氧血症 

分 类 号：R563.3[医药卫生—呼吸系统]