无创正压通气治疗急性心原性肺水肿72例临床体会(1)
 |
| 第1页 |
参见附件(1466KB，2页)。
[摘要] 目的:观察无创正压通气(NPPV)治疗急性心原性肺水肿的疗效。方法:对72例急性心原性肺水肿患者按照是否伴有明显的二氧化碳潴留,将其分为两组,PCO2>45 mm Hg组和PCO2<45 mm Hg组,两组再分为NPPV组和常规组,各18例。结果:PCO2>45 mm Hg组中,NPPV治疗后呼吸频率、心率、动脉血氧饱和度及气管插管率显著改善,死亡率也有降低趋势,两组比较差异有统计学意义(P<0.05),而PCO2<45 mm Hg组中,差异不明显。结论:对于无创通气治疗心原性肺水肿,当患者有明显的二氧化碳潴留时,疗效较好。
[关键词] 无创正压通气;急性心原性肺水肿;疗效观察
[中图分类号] R541.6+3 [文献标识码]A [文章编号]1673-7210(2010)05(c)-027-02
Clinical observation of noninvasive positive pressure ventilation in 72 patients with acute cardiac pulmonary edema
LIN Shaoyi, ZHONG Sheng, DENG Zhiqiang
(Respiratory Department, the Longjiang Hospital of Shunde District in Foshan City, Foshan 528318, China)
[Abstract] Objective: To study the effects on the treatment of acute cardiogenic pulmonary edema with noninvasive positive pressure ventilation. Methods: 72 patients with acute cardiogenic pulmonary edema were divided into two groups according to retention of carbon dioxide, the PCO2>45 mm Hg and PCO2<45 mm Hg group, and then each group was randomly divided into NPPV group (n=18) and control group (n=18). Results: The respiratory rate, heart rate, oxygen saturation and the rate of endotracheal intubation were significantly improved in the PCO2>45 mm Hg group with noninvasive positive pressure ventilation and the mortality also has decreasing trend (P<0.05), but in the PCO2<45 mm Hg group, the difference was not remarkable. Conclusion: The effect would be better when patients have retention of carbon dioxide on the treatment of acute cardiogenic pulmonary edema with noninvasive positive pressure ventilation.
[Key words] Noninvasive positive pressure ventilation; Acute cardiogenic pulmonary edema; Efficacy
急性心原性肺水肿(acute cardiogenic pulmonary edema,ACPE)是内科常见急症之一,常迅速出现呼吸、循环衰竭以及严重的低氧血症,是各种心脏病发展的严重阶段,如不及时救治可危及生命。近年来无创正压通气(NPPV)广泛应用于辅助治疗急性左心衰患者。为了观察NPPV治疗急性心原性肺水肿的疗效,并探讨应用NPPV呼吸机的指征,2006年12月～2009年12月我科采用无创(正压)机械通气及内科常规措施治疗ACPE患者72例,现报道如下:
1 资料与方法
1.1 一般资料
2006年12月～2009年12月我院收治急性心原性肺水肿72例,均有基础心脏疾病,其中,冠心病32例,高血压心脏病20例,肺源性心脏病13例,风湿性心脏病7例,均符合急性心原性肺水肿的诊断标准[1]。72例中,男34例,女38例;年龄50～80岁,平均(75 ......
您现在查看是摘要介绍页，详见PDF附件(1466KB，2页)。