无创正压通气救治急性心源性肺水肿的疗效观察.pdf

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1、中国当代医药2014年5月第21卷第14期·临床研究无创正压通气救治急性心源性肺水肿的疗效观察毕虹陈敏杜俊毅金志贤昆明市第一人民医院呼吸二科，昆明650011【摘要】目的探讨无创正压通气(NPPV)治疗急性心源性肺水肿(ACPE)的效果。方法将38例急性心源性肺水肿患者随机分为对照组和NPPV组，其中对照组19例，采用常规治疗；NPPV组19例，在常规治疗的基础上给予其无创正压通气。观察并比较两组患者治疗前后的心率(HR)、呼吸频率(RR)、血压(BP)、动脉血气分析(PH、PaO2、PaCO2)及治疗效果。结果两组治疗后的HR、BP、RR、PH、PaO2均明显改善；N

2、PPV组通气治疗后1、3h的BP、PaO2及治疗后1h的PH、RR较对照组改善更明显(P<0．05)，且NPPV组的有效率高于对照组(P

3、ogenicpulmonaryedemaBIHongCHENMinDUJun-yiJINZhi-xianDepartmentoftheSecondRespiratory，theFirstPeopleSHospitalofKunmingCity，Kunming650011,China[Abstract]ObjectiveTodiscusstheeffectofnoninvasivepositivepressureventilation(NPPV)inthetreatmentofa-cutecardiogenicpulmonaryedema(ACPE)．Methods38p

4、atientswithACPEwereevenlyandrandomlydividedintothecontrolgroupandtheNPPVgroup．Inthecontrolgroup．theconventionaltherapywasprovided．whileintheNPPVgroup，onthebasistreatmentofthecontrolgroup，NPPVwasadded．Theheartrate(HR)，respiratoryrate(RR)，bloodpres·sure(BP)，arterialbloodgasanalysisincludin

5、gPH，PaO2，andPaC02，andcurativeeffectbeforeandaftertreatmentwereobservedandcompared．ResultsAftertreatment，HR，BP，RR，PH，andPa02wereallimprovedinbothgroups．IntheNPPVgroup，BPandPaO2afterIhourand3hourstreatment，andPHandRRafterlhourtheratmentwereimprovedmoreremarkablythanthoseinthecontrolgroup'<

6、0．05)．TheeffectiverateintheNPPVgroupwashigherthanthatinthecontrolgroupfP<0．05)．ConclusionIncomparisonwithconventionaltherapy，NPPVtreatingACPEcanpromptlycorrectanoxiaandimprovecardio—pulmonaryfunction,whichobtainsadefiniteeffect．[Keywords]Noninvasivepositivepressureventilation(NPPV)；Acute

7、cardiogenicpulmonaryedema(ACPE)；Curativeef-fect急性心源性肺水肿(acutecardiogenicpulmonary心病3例、扩心病2例；心功能Ⅱ级3例、Ⅲ级l1例、edema，ACPE)是临床常见的急危重症，可导致呼吸困Ⅳ级5例。NPPV组l9例：男l4例，女5例；年龄难、低氧血症，很多研究和诊疗指南都提出无创正压(71．11~3．96)岁；冠心病10例、高心病5例、风心病2通气(noninvasivepositivepressureventilation，NPPV)例、扩心病2例；心功能Ⅱ