有创呼吸机实施无创正压通气与常规吸氧治疗急性心源性肺水肿的对比研究

有创呼吸机实施无创正压通气与常规吸氧治疗急性心源性肺水
肿的对比研究
尚云波;李嘉嘉;孙海燕;张留定;李华;钱智刚
【期刊名称】《中国急救医学》
【年(卷),期】2012(032)011
【摘要】Objective To evaluale the effects of noninvasive posilive pressure venlilalion (NPPV) on acute cardiogenic pulmonary edema by invasive venlilalor. Methods 82 palienls with acute cardiogenic pulmonary edema were divided into Lwo groups; 43 palienls were randomized to receive NPPV by invasive venlilalor based on conventional therapy as NPPV group;
39 palienls were randomized lo receive conventional oxygen therapy based on conventional therapy as conventional oxygen therapy group. We evaluale the trealmenl effecls by measuring the success rale of 2 h rescue and the general trealmenl efficiency of 2 h ( the success rale of 2 h rescue and the trealmenl efficiency of 2 h) , the inlubalion rale, the residence lime in emergency room and the rale of discharging from hospital, and by observing and comparing the complications and the side -effecls. Results Success rale of 2 h rescue; NPPV group was 60. 47% ( 26 of 43 ) , conventional oxygen therapy group was 17. 95% ( 7 of 39, P < 0.01); the general trealmenl efficiency of 2 h;NPPV group was 97. 67% (42 of 43 ) , conventional oxygen therapy group was 89. 74% (35 of 39,P = 0.
19) ;inlubalion rale;NPPV group was 2. 33% (1 of 43) , conventional oxygen
therapy group was 15. 38% (6 of 39 ,P = 0. 035) ; residence lime in emergency room;NPPV group was (2.61 ±0.23) h,conventional oxygen therapy group was (5.36 ±0.58) h,P < 0.01 ;lhe rale of discharging from hospital;NPPV group was 97. 67% (42 of 43) , conventional oxygen
therapy group was 89. 74% (35 of 39, P = 0. 068) ;side - effect rale:NPPV group was 11. 63% (5 of 43) ,conventional oxygen therapy group was 5. 13% (2 of 39 ,P =0. 293) . Conclusion The therapy of noninvasive positive pressure ventilation could increase the successful treatment rate of acute cardiogenic pulmonary edema by correctly using invasive ventilator, reducing intubation rate, shortening the residence time in emergency room, and could be used as adjunctive treatment of acute cardiogenic pulmonary edema in the case of the lack of noninvasive ventilator.%目的评价有创呼吸机实施无创正压通气(NPPV)在急性心源性肺水肿治疗中的作用.方法
82例急性心源性肺水肿患者随机分为NPPV组43例,常规吸氧组39例.除常规治
疗外,前者使用有创呼吸机给予NPPV,后者给予常规氧疗,以2 h抢救成功率、2 h
抢救总有效率、气管插管率、抢救室停留时间和幸存出院率评价治疗效果,观察比
较副反应和并发症发生率.结果 2 h抢救成功率:NPPV组60.47%(26例),常规吸氧
组17.95%(7例),两组比较差异有统计学意义(P＜0.01);2 h治疗总有效率(2 h抢救成功率+2 h抢救有效率):NIPPV组97.67%(42例),常规吸氧组89.74%(35例),两
组比较差异无统计学意义(P=0.19);气管插管率:NPPV组2.33%(1例),常规吸氧组15.38%(6例),两组比较差异有统计学意义(P=0.035);抢救室停留时间:NPPV组(2.61±0.23)h,常规吸氧组(5.36±0.58)h,两组比较差异有统计学意义(P＜0.01);幸
存出院率:NPPV组97.67%(42例),常规吸氧组89.74%(35例),两组比较差异无统
计学意义(P=0.068);副反应发生率:NPPV组11.63%(5例),常规吸氧组5.13%(2
例),两组比较差异无统计学意义(P=0.293).结论正确使用有创呼吸机实施NPPV能提高急性心源性肺水肿急诊抢救成功率,降低气管插管率,缩短抢救室停留时间,在缺乏无创呼吸机的情况下可以作为急性心源性肺水肿的辅助治疗手段.
【总页数】4页(P1037-1040)
【作者】尚云波;李嘉嘉;孙海燕;张留定;李华;钱智刚
【作者单位】650011,云南昆明,云南省第三人民医院急诊科;650011,云南昆明,云南省第三人民医院急诊科;650011,云南昆明,云南省第三人民医院急诊科;650011,云南昆明,云南省第三人民医院急诊科;650011,云南昆明,云南省第三人民医院急诊科;650011,云南昆明,云南省第三人民医院急诊科
【正文语种】中文
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