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目的探讨急性心源性肺水肿(ACPE)使用经鼻/面罩双水平正压通气(BiPAP)的救治方法。方法分析42例ACPE并发呼吸衰竭患者,经鼻/面罩连接呼吸机BiPAP无创通气救治,据患者反应调节呼吸机参数,2h好转后,分析比较治疗前后心功能分级改善情况,平均动脉压(MAP)、心率(HR)、呼吸频率(RR)、SpO2和动脉血气:PH、氧分压(PaO2)、二氧化碳分压(PaCO2)的变化。结果 BiPAP治疗2h后患者的MAP、HR、RR、SpO2和动脉血气中PH、PaO2较治疗前均改善显著,差异有统计学意义(P<0.05)。结论经鼻/面罩连接BiPAP无创通气可作为ACPE合并呼吸衰竭患者的首选治疗措施之一。尽早正确使用可以使许多ACPE患者避免有创通气。
Objective To investigate the treatment of acute cardiogenic pulmonary edema (ACPE) by nasal / facial mask bi-level positive pressure ventilation (BiPAP). Methods 42 patients with ACPE complicated with respiratory failure were treated with nasal / facial mask ventilator BiPAP noninvasive ventilation. The parameters of ventilator were adjusted according to the patient’s response. After 2 hours, the improvement of heart function grading, mean arterial pressure (MAP) , Heart rate (HR), respiratory rate (RR), SpO2 and arterial blood gas: PH, partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2). Results The MAP, HR, RR, SpO2 and arterial blood PH, PaO2 in BiPAP group were significantly improved after 2 hours of treatment (P <0.05). Conclusion Nasal / mask-attached BiPAP non-invasive ventilation can be used as one of the first choice of treatment for patients with ACPE complicated with respiratory failure. Correct use as soon as possible can enable many ACPE patients to avoid invasive ventilation.