急性心源性肺水肿 (acutecardiogenicpulmonaryede ma ,ACPE)是内科常见急症 ,传统的强心、利尿、扩血管等治疗能迅速改善病情 ,但对部分难治性ACPE难以奏效。近年来 ,无创正压通气 (NPPV)特别是双水平气道正压通气 (BiPAP)为治疗ACPE提供了新的方法[1～ 4 ] 。我们对急诊科收 Acute cardiogenic pulmonary edema (acutecardiogenicpulmonarydema, ACPE) is a common medical emergency, the traditional cardiac, diuretic, vasodilator and other treatment can quickly improve the condition, but some of the refractory ACPE is difficult to work. In recent years, non-invasive positive pressure ventilation (NPPV), especially bi-level positive airway pressure (BiPAP) provides a new method for the treatment of ACPE [1-4]. We receive emergency department