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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 mechanical ventilation in the treatment of acute severe cardiogenic pulmonary edema. Methods: Twenty-three cases of severe cardiogenic pulmonary edema complicated by acute respiratory failure were treated with mechanical ventilation through the endotracheal tube. The clinical symptoms and changes of arterial blood gas parameters, blood pressure, heart rate and respiration were observed before and after ventilation. Results: 22 patients were successfully rescued and 1 patient died. Compared with pre-ventilation, the symptoms of the patients improved obviously and the heart rate decreased after 2 hours of ventilation ([135 ± 49] min-1 / (106 ± 23) min-1, P <0.05] (52 ± 16)% / (95 ± 14)% of SaO2 and PaO2 increased to (7.3 ± 2.4) min-1 / (21.5 ± 8.9) min- P <0.01; (37.8 ± 12.6) mmHg / (78.9 ± 23.5) mmHg, P <0.01]. The pH value became normal [(7.11 ± 0.11) / (97.36 ± 0.07), P <0.05]. Conclusion: Artificial mechanical ventilation for acute severe cardiogenic pulmonary edema, can quickly relieve symptoms and correct hypoxemia, rescue effect is good.