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目的探讨呼吸机在急性心源性肺水肿抢救中的应用效果。方法 76例采用抗心力衰竭(心衰)、利尿、扩血管和补液等常规治疗以及双水平式呼吸道正压(BiPAP)无创呼吸机通气治疗的急性心源性肺水肿患者作为联合组,同时选取采用常规治疗的56例急性心源性肺水肿患者作为常规组,并比较两组患者临床治疗效果、联合组患者治疗前后呼吸频率、心率、血压、血气分析和血氧饱和度等指标变化情况。结果联合组患者治疗后好转70例,死亡6例,好转率为92.1%,对照组患者治疗后好转29例,死亡27例,好转率为51.8%,两组比较差异具有统计学意义(P<0.05);与治疗前比较,治疗后联合组患者呼吸频率、心率、平均动脉压、动脉血二氧化碳分压、心功能均明显改善(P<0.05)。结论对老年急性心源性肺水肿患者采取BiPAP无创呼吸机通气治疗有助于改善患者心肺功能,减少患者死亡率,是临床一种抢救急性肺源性水肿较为有效和安全的方法。
Objective To investigate the application of ventilator in the rescue of acute cardiogenic pulmonary edema. Methods A total of 76 patients with acute cardiogenic pulmonary edema treated by conventional therapy such as heart failure, diuretic, vasodilatation and rehydration, and bi-level positive airway pressure (BiPAP) non-invasive ventilator were selected as the joint group Fifty-six patients with acute cardiogenic pulmonary edema treated by routine therapy were selected as the routine group. The clinical effects of the two groups were compared. The changes of respiratory rate, heart rate, blood pressure, blood gas analysis and oxygen saturation before and after treatment were compared between the two groups. Results After treatment, 70 cases improved and 6 cases died, the improvement rate was 92.1%. In the control group, 29 cases improved after treatment and 27 cases died, the improvement rate was 51.8%. The difference between the two groups was statistically significant (P < 0.05). Compared with those before treatment, respiratory rate, heart rate, mean arterial pressure, arterial partial pressure of carbon dioxide and heart function in the combined group were significantly improved after treatment (P <0.05). Conclusion BiPAP noninvasive ventilator ventilation in elderly patients with acute cardiogenic pulmonary edema can improve cardiopulmonary function and reduce mortality in patients. It is an effective and safe method to rescue acute pulmonary edema.