摘要
目的 研究经面罩机械通气(FMMV)对急性肺水肿的治疗效果。方法 34例肺水肿患者,分为对照组12例,采用常规治疗;治疗组22例,在常规治疗的基础上或常规治疗效果不佳的情况下给予FMMV,观察临床表现、胸部X线片和动脉血气的变化。结果 FMMV后30min内,91％的患者能较好耐受,所有患者呼吸困难皆明显改善,呼吸频率由(37±7)次/min降至(26±5)次/min(P<0.05),心率由(122±21)次/min降至(94±27)次/min(P<0.05),4例(18％)低血压患者血压迅速回升。77％的患者24h内咳嗽、咳痰和肺部湿啰音基本缓解。临床症状的总体好转速度治疗组明显高于对照组。吸氧流量相同的情况下,治疗组1h后PaO_2由(62±10)mm Hg升至(78±18)mm Hg(P<0.05),2～6h后升至(96±22)mm Hg(P<0.05),PaO_2升高的速度和幅度皆较对照组显著;脱机时,治疗组在吸空气条件下PaO_2维持在(79±8)mm Hg(P<0.05),PaCO_2和pH也逐渐恢复正常。95％的患者在24～48h内脱离呼吸机。结论 与常规治疗相比,FMMV可迅速改善心功能,并更快改善肺水肿和低氧血症。
Objective To evaluate the effects of face mask mechanical ventilation(FMMV) on treatment of acute pulmonary edema.Methods The study included 34 patients with acute pulmonary edema,22 patients received FMMV based on conventional treatments, or after failure of conventional treatment and 12 patients only received general treatments( control group) .The symptoms and signs, the chest X-ray appearance, and artery blood gases were gathered and analyzed. Results After 30 mimutes via FMMV20 patients had good compliance,while dyspnoea was improved markedly,respiratory rates decreased from (37±7)times/min to (26 +5)times/min (P<0.05), heart rates decreased from (122± 21) times/ min to (94 ± 27) times/ min (P < 0.05). The blood pressure of 4 patients with prior hypoten-tion was improved rapidly, and the others were stable. The cough, expect oration and moist rale of lung of all patients were disappeared basically in 24 hours.The symptoms of these patients were improved more rapidly than those in control group.The artery blood gases analysis showed that Pap2 rose from (62 ± 10) mm Hg to (78± 18) mm Hg after 1 hours(P<0.05) ,and to (96 + 22) mm Hg after 2-6 hours (P< 0.05),PaO2 of these patients was improved more rapidly than control group, PaCO2 and pH was also gradually improved to normal ranges.21 patients were weaned from ventilator in 24-48 hours, another one was after 4 days.Without menchanic ventilation,the PaO2 was (79±8) mm Hg (P<0.05) during freely breathing airs.Conclusion FMMV can improved cardiac function, pulmonary edema and hypox-emia more rapidly than conventional therapy.
出处
《中国呼吸与危重监护杂志》
CAS
2002年第4期217-220,共4页
Chinese Journal of Respiratory and Critical Care Medicine
