摘要
目的:评估经面罩压力支持非侵入性正压通气(NIPPV)对急性心源性肺水肿(ACPE)患者的疗效。方法:54例急诊就诊、ACPE所致急性呼吸衰竭需要气管插管的成年患者,除了常规给予持续氧疗、硝酸酯类药物和利尿剂,还应用NIPPV治疗。观察治疗前、后患者动脉血气分析、Borg呼吸困难评分、生命体征和是否需要气管内插管。结果:54例患者NIPPV治疗60min后的血pH、PaCO2、PaO2、SaO2、Borg评分、呼吸频率较治疗前明显改善(均P<0.05)。49例患者(90.7%)症状改善后,停止应用NIPPV,5例合并严重慢性阻塞性肺病(COPD)患者需要气管内插管。NIPPV治疗患者无并发症出现。结论:NIPPV能迅速改善ACPE患者低氧血症,使其避免了气管插管,是抢救ACPE的一种安全有效的方法。
Objective：To evaluate the effect of noninvasive positive pressure ventilation （NIPPV） via face mask in treatment of acute cardiogenic pulmonary edema （ACPE）. Methods ： Fifty-four adult patients with severe acute respiratory failure resulted from cardiogenic pulmonary edema received NIPPV based on conventional treatments consisting of oxygen, nitrates, and diuretics. Patients＇ arterial blood gas analysis, Borg dyspnea score, vital signs, and requirement for endotracheal intubation （ETI） were observed before and after treatments. Results：Patients＇blood pH,PaCO2 ,PaO2 ,SaO2 ,Borg score and respiratory rate were improved significantly after treatment with NIPPV for 60 minutes than those before treatment （P 〈 0.05）. The symptoms were improved in 49 patients （90, 7% ） ,5 patients complicated with severe chronic obstructive pulmonary disease （COPD） and required ETI. No complication occurred in patients with NIPPV. Conclusion： NIPPV can improve hypoxemia rapidly. It is an effective treatment for ACPE and may help to avoid ETI.
出处
《内科急危重症杂志》
2012年第6期360-361,共2页
Journal of Critical Care In Internal Medicine
关键词
急性心源性肺水肿
急性呼吸衰竭
无创正压通气
Acute cardiogenic pulmonary edema Acute respiratory failure Noninvasive positive pressure ventilation
