双水平气道正压无创通气治疗急性心源性肺水肿患者的临床分析

摘要

Objective To observe the clinical efficacy of non-invasive bi-level positive airway pres-sure ventilation (BiPAP)in the treatment of patients with acute cardiogenic pulmonary edema.Methods Eighty-five patients with acute cardiogenic pulmonary edema were retrospectively analyzed and assigned into two groups.In the treatment group,fifty cases were treated with BiPAP non-invasive ventilation on the basis of anti-heart failure treatment such as positive inotropic,diuretics and vasoactive drugs.In the control group,35 pa-tients underwent oxygen masks based upon anti-heart failure therapy.The clinical effects in two groups were compared.Results Compared with the control group,the clinical symptoms of the patients,who treated with BiPAP non-invasive ventilation,were significantly improved,and 6-hour lactic acid clearance rate and effective rate were significantly higher (all P <0.05),whereas endotracheal intubation rate and mortality were signifi-cantly lower (both P <0.05).Conclusion BiPAP can alleviate the symptoms of patients with acute cardio-genic pulmonary edema and reduce endotracheal intubation rate and mortality.%目的：观察双水平气道正压（BiPAP）无创通气治疗急性心源性肺水肿患者的临床疗效。方法收集85例急性心源性肺水肿患者的治疗情况，其中给予正性肌力药物、利尿药、血管活性药物等常规抗心力衰竭治疗的基础上行 BiPAP 无创通气治疗的50例患者作为治疗组，给予面罩吸氧等常规抗心力衰竭治疗的35例患者为对照组。比较两组的临床疗效。结果与对照组比较，治疗组患者经 BiPAP 无创通气治疗后，患者的临床症状改善更明显，6 h 乳酸清除率及治疗有效率均明显高于对照组（P 均＜0.05），气管插管率及病死率均明显低于对照组（P 均＜0.05）。结论BiPAP 无创通气能迅速改善急性心源性肺水肿患者的临床症状，降低气管插管率及病死率。