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1、無創(chuàng)正壓通氣救治急性心源性肺水腫的療效觀察[摘要]目的探討無創(chuàng)正壓通氣(NPPV)治療急性心源性肺水腫(ACPE)的效果。方法將38例急性心源性肺水腫患者隨機(jī)分為對(duì)照組和NPPV組,其中對(duì)照組19例,采用常規(guī)治療;NPPV組19例,在常規(guī)治療的基礎(chǔ)上給予其無創(chuàng)正壓通氣。觀察并比較兩組患者治療前后的心率(HR)、呼吸頻率(RR)、血壓(BP)、動(dòng)脈血?dú)夥治觯≒H、PaO2、PaCO2)及治療效果。結(jié)果兩組治療后的HR、BP、RR、PH、PaO2均明顯改善;NPPV組通氣治療后1、3h的BP、PaO2及治療后1h的PH、RR較對(duì)照組改善更明顯(P<0.05),且NPPV組的有效
2、率高于對(duì)照組(P<0.05)。結(jié)論無創(chuàng)正壓通氣治療急性心源性肺水腫較常規(guī)治療能迅速糾正缺氧及改善心肺功能,療效肯定。[關(guān)鍵詞]無創(chuàng)正壓通氣;急性心源性肺水腫;療效[中圖分類號(hào)]R541.6+3[文獻(xiàn)標(biāo)識(shí)碼]A[文章編號(hào)]1674-4721(2014)05(b)-0055-04Curativeeffectobservationofnoninvasivepositivepressureventilationinthetreatmentofacutecardiogenicpulmonaryedema12BIHongCHENMinDUJun-yiJINZhi-xianDepartm
3、entoftheSecondRespiratory,theFirstPeople′sHospitalofKunmingCity,Kunming650011,China[Abstract]ObjectiveTodiscusstheeffectofnoninvasivepositivepressureventilation(NPPV)inthetreatmentofacutecardiogenicpulmonaryedema(ACPE).Methods38patientswithACPEwereevenlyandrandomlydividedintothecontrolgrou
4、pandtheNPPVgroup.Inthecontrolgroup,theconventionaltherapywasprovided,whileintheNPPVgroup,onthebasistreatmentofthecontrolgroup,NPPVwasadded.Theheartrate(HR),respiratoryrate(RR),bloodpressure(BP),arterialbloodgasanalysisincludingPH,PaO2,andPaCO2,andcurativeeffectbeforeandaftertreatmentwereob
5、servedandcompared.ResultsAftertreatment,HR,BP,RR,PH,andPaO2wereallimprovedinbothgroups.IntheNPPVgroup,BPandPaO2after1hourand3hourstreatment,andPHandRRafter1hourtheratmentwereimprovedmoreremarkablythanthoseinthecontrolgroup(P<0.05).TheeffectiverateintheNPPVgroup12washigherthanthatinthecontr
6、olgroup(P<0.05).ConclusionIncomparisonwithconventionaltherapy,NPPVtreatingACPEcanpromptlycorrectanoxiaandimprovecardio-pulmonaryfunction,whichobtainsadefiniteeffect.[Keywords]Noninvasivepositivepressureventilation(NPPV);Acutecardiogenicpulmonaryedema(ACPE);Curativeeffect急性心源性肺水腫(acutecardi
7、ogenicpulmonaryedema,ACPE)是臨床常見的急危重癥,可導(dǎo)致呼吸困難、低氧血癥,很多研究和診療指南都提出無創(chuàng)正壓通氣(noninvasivepositivepressureventilation,NPPV)對(duì)ACPE患者具有改善氧合、增加心排血量、減少呼吸做功等作用,可縮短患者的病程。本研究選取本科住院發(fā)生ACPE的患者38例,隨機(jī)分為對(duì)照組和NPPV組,進(jìn)行了臨床療效的觀察。1資料與方法1.1一般資料12選取2008年2月~2013年12月在本科住院發(fā)生ACPE的患者38例為研究對(duì)象。將患者隨