机械通气在急诊抢救急性肺水肿中的应用

目的:探讨机械通气在急诊抢救急性肺水肿的临床疗效.方法:回顾性分析我院2003年1月至2009年12月我科应用机械通气辅助治疗急性肺水肿患者124例的临床资料.结果:124例中86例采用无创正压通气,38例采用有创正压通气,有创正压通气组的APACHE Ⅱ评分显著高于无创通气组(P＜0.05).所有患者机械通气2 h后呼吸困难明显缓解,心率、呼吸频率显著改善,均P＜0.01,APACHE Ⅱ评分明显改善(P＜0.05),动脉血氧分压及动脉血氧饱和度均明显升高(均P＜0.05).结论:机械通气可有效改善急性肺水肿患者的临床症状,减轻呼吸窘迫,迅速纠正低氧血症,提高抢救成功率.

The Application of Mechanical Ventilation in Patients with Acute Pulmonary Edema

Objective： To explore the effect of mechanical ventilation in emergency rescue for patients with acute puhnonary edema. Methods：The clinical data of 124 patients with acute puhnonary edema rescued by mechanical ventilation were retrospectively analyzed from Jan 2003 to Dec 2009. Results： Among 124 cases, 86 were treated by noninvasive positive pressure ventilation （NIPPV）, 38 were treated by invasive positive pressure ventilation （IPPV）. The acute physiology and chronic health score （APACHE II scores） in IPPV group was significantly higher than that in IPPV group （P〈0.05）. After using mechanical ventilation 2 h,all the cases relieved breathing difficulty and significantly improved the heart rate （P〈0.01）,respiratopy rate （P〈0.01）,APACHE Ⅱ（P〈0.05）,arterial partial pressure of oxygen （P〈0.05） and arterial oxygen saturation （P〈0.05）. Conclusion： The patients with acute pulmonary edema can be effective in improving clinical symptoms by application mechanical ventilation, reduce dyspnea, rapid colTection of hypoxemia and improve the success rate.