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目的:探讨无创机械通气双水平正压通气(BiPAP)模式与持续正气道压通气(CPAP)模式治疗急性心源性肺水肿(ACPE)的临床疗效。方法:65例ACPE患者在应用常规吸氧及药物治疗基础上随机分为BiPAP组(n=33)和CPAP组(n=32),分别联用无创呼吸机进行BiPAP和CPAP模式治疗,比较两组临床症状和体征、动脉血气分析及N末端利钠肽前体(NT-proBNP)等。结果:两组患者治疗后临床症状、体征明显改善,呼吸频率、心率、平均动脉压及NT-proBNP均较治疗前显著降低(P<0.01),PaO_2、SaO_2较治疗前显著增高(P<0.01),BiPAP组(n=33)的总有效率100.0%与CPAP组(n=32)的96.88%无显著性差异(P>0.05)。结论:无创机械通气BiPAP和CPAP治疗ACPE均疗效显著。
Objective: To investigate the clinical efficacy of BiPAP and continuous positive airway pressure (CPAP) in the treatment of acute cardiogenic pulmonary edema (ACPE). Methods: Sixty-five patients with ACPE were randomly divided into BiPAP group (n = 33) and CPAP group (n = 32) on the basis of routine oxygen inhalation and drug treatment. The patients were treated with noninvasive ventilator for BiPAP and CPAP respectively. Group clinical symptoms and signs, arterial blood gas analysis and N-terminal pro-natriuretic peptide precursor (NT-proBNP) and so on. Results: The clinical symptoms and signs of the two groups were significantly improved after treatment. The respiratory rate, heart rate, mean arterial pressure and NT-proBNP were significantly lower than those before treatment (P <0.01), and PaO_2 and SaO_2 were significantly increased (P <0.01) ). The total effective rate of 100.0% in BiPAP group (n = 33) was not significantly different from 96.88% in CPAP group (n = 32) (P> 0.05). Conclusion: Non-invasive mechanical ventilation BiPAP and CPAP treatment of ACPE were significant effect.