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目的 研究应用非侵入性呼吸机治疗急性心源性肺水肿的临床价值。方法 对31名难治性急性心源性肺水肿的患者应用非侵入性鼻面罩双相气道正压通气 (BiPAP)治疗 ,观察通气前后心率、尿量、平均血压 (MAP)、血氧饱和度 (SaO2 )、呼吸频率、呼气末二氧化碳分压 (PetCO2 )、血气分析和心功能等指标的变化。结果 患者经 2～ 6h的鼻面罩BiPAP治疗后心率明显减慢 (P <0 0 0 1)、尿量明显增加 (P <0 0 0 1)、PaO2 和SaO2 明显提高 (P <0 0 0 1)、PaCO2 和PetCO2 改变不明显 (P >0 0 5 )、心功能明显改善、高血压心脏病者MAP下降显著 (P<0 0 0 1)。结论 对急性心源性肺水肿应用非侵入性鼻面罩BiPAP治疗是安全而有效的 ,值得在临床推广使用
Objective To study the clinical value of noninvasive ventilator in the treatment of acute cardiogenic pulmonary edema. Methods Thirty-one patients with refractory acute cardiogenic pulmonary edema were treated with BiPAP without nasal mask. The changes of heart rate, urine output, mean blood pressure (MAP), oxygen saturation (SaO2), respiratory rate, partial pressure of end-tidal carbon dioxide (PetCO2), blood gas analysis and cardiac function and other indicators of change. Results After 2 ~ 6h nasal mask BiPAP treatment, the heart rate was significantly slowed down (P 0 01), urine output increased significantly (P 0 01), PaO2 and SaO2 increased significantly (P 0 01 0 ), PaCO2 and PetCO2 changed insignificantly (P> 0.05), heart function improved significantly, MAP in hypertensive heart disease decreased significantly (P <0.01). Conclusion The application of non-invasive nasal mask BiPAP in the treatment of acute cardiogenic pulmonary edema is safe and effective, which is worthy of clinical application