【摘要】 【目的】观察短期Bi-PAP通气治疗老年急性心源性肺水肿临床疗效。【方法】老年急性心源性肺水肿病人23例,随机分为常规治疗组12例,Bi-PAP组11例,比较Bi-PAP通气及常规吸氧治疗的疗效,并观察Bi-PAP通气对心脏功能的影响。【结果】Bi-PAP通气组经治疗后,30 min至3 h后呼吸困难开始好转,最快10 min,血气指标改善多在1~3 h。常规治疗组治疗后2~4 h呼吸困难好转,血气指标改善多在3~4h;两组比较,Bi-PAP组治疗有效率及达到有效所需时间优于常规治疗(P<0.05),好转率差异无显著性,但达到好转所需时间短(P<0.05),气管插管率差异无显著性。Bi-PAP组3例病人发生面罩局部皮肤损伤,常规治疗组无并发症发生(P<0.05)。使用Bi-PAP通气治疗4 h后,左室射血分数及E/A差异无显著性,但后Tei较上机前有提高(P<0.05)。【结论】早期应用Bi-PAP可较快地缓解心源性肺水肿的临床症状,并可改善心脏功能。更多还原

【Abstract】 【Objective】To investigate the role of bi-level positive airway pressure(bi-PAP) mechanical ventilation in treatment of elderly patients with acute cardiogenic pulmonary edema.【Methods】Twenty three elderly patients with acute cardiogenic pulmonary edema were randomly assigned to conventional oxygen therapy or Bi-PAP mechanical ventilation,effects of the two treatment ways,the role of Bi-PAP on heart function were investigated.【Results】In Bi-PAP group,after the administration of ventilation,the dyspnea was reduced in 30min～3 h,blood gas index improved in 1~3h.In conventional oxygen therapy group,the dyspnea was reduced in 1～3 h,blood gas index improved in 3~4 h.In Bi-PAP group,effective rate was higher,but the time needed to improve was shorter,3 patients developed minor facial erythema as a result of the face mask,Tei increased after treatment.【Conclusion】In elderly patients with acute cardiogenic pulmonary edema,noninvasive ventilation can decrease pulmonary edema more quickly,at the same time,improve heart function.更多还原