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目的:评价无创正压无创通气(NIPPV)治疗急性高原肺水肿(high-altitude pulmonaryedema,HAPE)的临床疗效。方法:高原肺水肿患者30例,随机分为实验组和对照组(常规药物治疗)各15例。观察两组患者治疗前、治疗后2h和24h心率、呼吸以及血气分析的变化。结果:实验组无创通气2h后的心率和呼吸明显降低(P<0.01或0.05,呼吸困难均改善,PaO2显著升高P<0.01,对照组在相应治疗时间内上述指标无显著变化,实验组24小时后氧分压继续上升,1例因意识障碍加重改有创通气,总有效率93.33%,而对照组氧分压缓慢上升,3例治疗无效改有创通气,总有效率为80.00%。结论:NIPPV对急性高原性肺水肿效果良好,较单纯药物治疗能更快地缓解症状。改善动脉血气和减少插管率。
Objective: To evaluate the clinical efficacy of noninvasive positive pressure noninvasive ventilation (NIPPV) in the treatment of acute high altitude pulmonary edema (HAPE). Methods: 30 cases of high altitude pulmonary edema patients were randomly divided into experimental group and control group (conventional drug treatment) in 15 cases. The change of heart rate, respiration and blood gas analysis before treatment, 2h and 24h after treatment were observed in two groups of patients. Results: In the experimental group, heart rate and respiration decreased significantly after 2 hours of ventilation (P <0.01 or 0.05, dyspnea improved, PaO2 significantly increased, P <0.01), while there was no significant change in the control group over the corresponding treatment time. Oxygen partial pressure continued to rise after 1 hour. One case of invasive ventilation resulted from aggravated disturbance of consciousness. The total effective rate was 93.33%. In the control group, the partial pressure of oxygen increased slowly. Three cases were treated with invasive ventilation without ventilation. The total effective rate was 80.00%. Conclusion: NIPPV is effective in acute high altitude pulmonary edema, which can relieve symptoms more quickly than simple drug therapy, improve arterial blood gas and reduce intubation rate.