摘要
目的 评估机械通气对急性心肌梗死所致急性危重型肺水肿的治疗效果。方法 回顾性分析9例接受经口气管插管机械通气治疗急性心肌梗死所致肺水肿病例，观察机械通气治疗后临床表现、肺部X线片及动脉血气的变化。结果 机械通气30min后，所有病例均良好耐受，呼吸困难明显缓解；心率和呼吸频率明显下降（P〈0．01），动脉血气指标明显改善（P〈0．01）；血压稳定，72～96h所有患者停用升压药；所有患者于72h复查肺部X线片，6例提示肺水肿缓解或消退，3例好转。9例患者中8例患者均在12d内脱离呼吸机，生命征象平稳；1例患者撤机前（机械通气第7d）突发心跳停止死亡。结论 机械通气能迅速缓解急性心肌梗死所致急性危重型肺水肿的症状和低氧血症，更快地改善心功能。
Objective To evaluate the effects of mechanical ventilation （MV） on acute pulmonary edema due to acute myocardial infarction. Methods Nine patients with acute cardiogenic pulmonary edema caused by acute myocardial infarction admitted to the coronary care unit （CCU） were investigated retrospectively. All patients received mechanical ventilation based on routine therapies. Changes of symptoms, radiography and arterial blood gas were observed. Results After ventilation for 30 minutes, all patients showed a significant improvement in dyspnea. Heart rate and respiratory rate were decreased significantly after ventialtion （ P 〈 0.01 ） with significant improvement of arterial blood gas parameters （ P 〈 0.01 ）. During ventialtion blood pressure remained stable, and no adverse effects were observed. Pressor agents could be withdrawn in all patients 72 to 96 hours after ventialtion. Chest films at 72 hours showed remission of pulmonary edema in 6 cases and considerable improvement in 3 cases. Eight patients were successfully weaned from mechanical ventilation within 12 days. One patient died of sudden heart alrest on the seventh day after ventilation. Conclusion Mechanical ventilation can quickly relieve the symptoms of acute cardiogenic pulmonary edema and improve cardiac function.
出处
《中国呼吸与危重监护杂志》
CAS
2006年第4期256-259,共4页
Chinese Journal of Respiratory and Critical Care Medicine
关键词
机械通气
急性心肌梗死
急性肺水肿
心功能
Mechanical ventilation
Acute myocardial infarction
Acute pulmonary edema
Cardiac function
