無創(chuàng)正壓通氣救治急性心源性肺水腫的療效觀察.pdf

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1、中國當代醫(yī)藥2014年5月第21卷第14期·臨床研究無創(chuàng)正壓通氣救治急性心源性肺水腫的療效觀察畢虹陳敏杜俊毅金志賢昆明市第一人民醫(yī)院呼吸二科，昆明650011【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分為對照組和NPPV組，其中對照組19例，采用常規(guī)治療；NPPV組19例，在常規(guī)治療的基礎上給予其無創(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)、動脈血氣分析(PH、PaO2、PaCO2)及治療效果。結果兩組治療后的HR、BP、RR、PH、PaO2均明顯改善；N

2、PPV組通氣治療后1、3h的BP、PaO2及治療后1h的PH、RR較對照組改善更明顯(P<0．05)，且NPPV組的有效率高于對照組(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急性心源性肺水腫(acutecardiogenicpulmonary心病3例、擴心病2例；心功能Ⅱ級3例、Ⅲ級l1例、edema，ACPE)是臨床常見的急危重癥，可導致呼吸困Ⅳ級5例。NPPV組l9例：男l(wèi)4例，女5例；年齡難、低氧血癥，很多研究和診療指南都提出無創(chuàng)正壓(71．11~3．96)歲；冠心病10例、高心病5例、風心病2通氣(noninvasivepositivepressureventilation，NPPV)例、擴心病2例；心功能Ⅱ