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急性心源性肺水肿引起的呼吸衰竭是气管插管的常见原因之一,而无创通气治疗使部分患者避免气管插管和相关的并发症。临床常用的无创通气模式是持续正压通气和无创正压通气两种,均能够改善急性心源性肺水肿患者的生命体征、生理指标,降低插管率。理论上推测,无创正压通气优于持续正压通气,但临床试验研究并没有发现无创正压通气在降低插管率和病死率方面有优势。现对持续正压通气和无创正压通气治疗急性心源性肺水肿的随机对照试验做一综述,为临床治疗提供循证依据。
Respiratory failure caused by acute cardiogenic pulmonary edema is one of the common causes of endotracheal intubation, while noninvasive ventilatory therapy in some patients to avoid endotracheal intubation and related complications. Commonly used non-invasive ventilation mode is continuous positive pressure ventilation and noninvasive positive pressure ventilation, both can improve the vital signs and physiological indicators of patients with acute cardiogenic pulmonary edema, reduce the rate of intubation. Theoretically, noninvasive positive pressure ventilation is superior to continuous positive pressure ventilation, but clinical trials and did not find noninvasive positive pressure ventilation in reducing the intubation rate and mortality advantages. Now continuous positive pressure ventilation and noninvasive positive pressure ventilation in the treatment of acute cardiogenic pulmonary edema randomized controlled trials are reviewed to provide evidence-based clinical evidence.