目的探讨无创机械通气(NMV)治疗急性心源性肺水肿(ACPE)的临床应用价值。方法对80例各种原因所致的急性肺水肿患者随机分为NMV治疗组39例和对照组41例,对照组常规药物治疗加鼻导管高流量吸氧,NMV治疗组在常规药物治疗的基础上给予压力支持通气(PSV)加呼吸末正压(PEEP)通气模式,分别监测治疗前及治疗后的临床表现、动脉血气分析、血氧饱和度、呼吸频率、心率、血压等变化。结果治疗组治疗后,39例患者均于30min内症状缓解,除3例较重患者需辅助通气2h才能撤机外,其他均于1h内撤机。撤机后能平卧呼吸,面色恢复正常、大汗消失、口唇无青紫、泡沫样痰消失、双肺啰音明显减少甚至消失阶榱俅哺飨钪副瓯冉喜钜炀哂型臣蒲б庖澹?P<0.05)。结论在常规强心、利尿、扩管等基础治疗同时,加用无创双水平正压机械通气治疗急性肺水肿,可迅速纠正缺氧、改善病情、提高抢救成功率,减少气管插管及气管切开率,降低死亡率。 Objective To investigate the clinical value of noninvasive mechanical ventilation (NMV) in the treatment of acute cardiogenic pulmonary edema (ACPE). Methods A total of 80 patients with acute pulmonary edema caused by various causes were randomly divided into NMV treatment group (n = 39) and control group (n = 41). The control group received conventional high-flow nasal cannula oxygen inhalation. (PSV) and positive end-expiratory pressure (PEEP) ventilation mode. The changes of clinical manifestations, arterial blood gas analysis, oxygen saturation, respiratory rate, heart rate and blood pressure before and after treatment were monitored. Results After treatment, all the 39 patients were relieved of symptoms within 30 minutes. Except for 3 cases of severe cases, patients in need of assisted ventilation were able to weaning for 2 hours, while others were weaned within 1 hour. After weaning can supine breathing, looking back to normal, sweating disappeared, lips without bruising, foam-like sputum disappeared, pulmonary rales significantly reduced or even disappear  order 榱 俅 Nursery scandium Vice Ou Ran 喜 huge 炀  哂 type minister Pu б庖 澹? P <0.05). Conclusions In the treatment of acute pulmonary edema, such as cardiac, diuretic and expanding tube can be treated with noninvasive and bi-level positive pressure mechanical ventilation at the same time, which can quickly correct the hypoxia and improve the condition, improve the success rate of rescue and reduce tracheal intubation and tracheotomy Open rate, reduce mortality.