CAJ | 학술논문

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＜0.001)、尿量明显增加(P＜0.001)、PaO2和SaO2明显提高(P＜0.001)、PaCO2和PetCO2改变不明显(P＞0.05)、心功能明显改善、高血压心脏病者MAP下降显著(P＜0.001)。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。
목적 연구응용비침입성호흡궤치료급성심원성폐수종적림상개치。방법 대31명난치성급성심원성폐수종적환자응용비침입성비면조쌍상기도정압통기(BiPAP)치료，관찰통기전후심솔、뇨량、평균혈압(MAP)、혈양포화도(SaO2)、호흡빈솔、호기말이양화탄분압(PetCO2）、혈기분석화심공능등지표적변화。결과 환자경2～6h적비면조BiPAP치료후심솔명현감만(P＜0.001)、뇨량명현증가(P＜0.001)、PaO2화SaO2명현제고(P＜0.001)、PaCO2화PetCO2개변불명현(P＞0.05)、심공능명현개선、고혈압심장병자MAP하강현저(P＜0.001)。결론 대급성심원성폐수종응용비침입성비면조BiPAP치료시안전이유효적，치득재림상추엄사용。
Objective To evaluate the clinical applications of noninvasive ventilation in the treatment of acute cardiogenic pulmonary edema．Methods Thirty one patients with acute cardiogenic pulmonary edema（ACPE）were treated with noninvasive nasal mask bilevel positive airway pressure（BiPAP）．Before and after ventilatory support，the heart rate，breathing rate，urine volume，MAP，SaO2，PetCO2，PaO2，PaCO2 and heart function were recorded．Results After 2～6 hours treatment，the heart rate and breathing rate were significantly reduced（P＜0.001）．The urine volume，SaO2 and PaO2 were markedly increased （P＜0.001）．The MAP were decreased in hypertensive patients（P＜0.001）．All patients’ heart function was improvement．PetCO2and PaCO2 were not changed very much（P＞0.05）．Conclusion The noninvasive nasal mask BiPAP is a kind of safe and effective method in the treatment of ACPE．It can be recommended for clinical use．