[摘要] 目的评价无创正压通气治疗急性心源性肺水肿的疗效。方法选择36例急性心源性肺水肿患者，在高流量吸氧及常规药物治疗不能纠正缺氧时，经面罩给予无创正压通气，观察治疗前、治疗后0.5h、1h、2h后临床症状、体征和动脉血气分析的变化。结果经面罩无创正压通气治疗后，36例患者中32例(88.89%)临床症状、体征明显改善，血气分析中PaO 2 明显升高(P<0.01)、PaCO 2 有所下降(P<0.05)，避免了进一步有创机械通气治疗带来的损伤和经济负担;4例(11.11%)经无创正压通气治疗无效，改为经口气管插管机械通气;死亡2例。结论应用无创正压通气可明显改善急性心源性肺水肿患者的症状、体征和血气分析结果，可作为急性心源性肺水肿安全、快速、有效的治疗手段之一。

    [关键词]无创正压通气;急性心源性肺水肿;左心衰竭

    Clinical study of non-invasive positive pressure ventilation in the treatment of36patients with acute cardiogenic pulmonary edema

    CHEN Zengrui，ZHENG Xiaojin，ZHOU Zhaoyang，GAN Yongxiong.Yuhuan People's Hospital，Yuhuan317600，China

    [Abstract] Objective To estimate the efficacy of non-invasive positive pressure ventilation(NIPPV)in the treatment of the patients with acute cardiogenic pulmonary edema(ACPE).Method36adult patients with ACPE who were of no effect with high flow oxygen and routine drugs were treated with NIPPV by face masks.The changes of parameters in-cluding symptom，sign and arterial blood gas were observed before treatment and at thirty minutes ......