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目的观察无创正压通气治疗急性心源性肺水肿的临床疗效。方法 44例急性心源性肺水肿依据是否应用无创通气(noninvasive ventilation,NIV)分为NIV组30例和常规治疗组14例,监测2组治疗前、后各项生理指标、动脉血气分析、血乳酸和血B型利钠肽的变化。结果与治疗前比较,NIV组治疗后心率、血压、呼吸频率、脉搏血氧饱和度、氧分压、乳酸和B型利钠肽水平有明显改善;常规治疗组仅血压、呼吸频率、脉搏血氧饱和度、氧分压和B型利钠肽水平有改善(P<0.05);治疗后NIV组心率、呼吸频率、脉搏血氧饱和度、pH值、氧分压和B型利钠肽水平均较常规治疗组改善明显(P<0.05);NIV组气管插管率低于常规治疗组(P<0.05)。结论 NIV是治疗急性心源性肺水肿快速有效的方法,疗效可靠。
Objective To observe the clinical efficacy of noninvasive positive pressure ventilation in the treatment of acute cardiogenic pulmonary edema. Methods Forty-four patients with acute cardiogenic pulmonary edema were divided into NIV group (n = 30) and routine group (n = 14) according to whether noninvasive ventilation (NIV) was applied or not. The physiological indexes, arterial blood gas analysis Changes of lactate and blood B-type natriuretic peptide. Results Compared with those before treatment, heart rate, blood pressure, respiratory rate, pulse oximetry, oxygen partial pressure, lactate and B-type natriuretic peptide were significantly improved in NIV group. The blood pressure, respiratory rate, Oxygen saturation, oxygen partial pressure and B-type natriuretic peptide were improved (P <0.05). After treatment, heart rate, respiratory rate, pulse oximetry, pH value, oxygen partial pressure and B-type natriuretic peptide (P <0.05). The tracheal intubation rate in NIV group was lower than that in routine treatment group (P <0.05). Conclusion NIV is a fast and effective method for the treatment of acute cardiogenic pulmonary edema and has reliable curative effect.