呼气末正压通气治疗重型颅脑损伤后神经源性肺水肿的疗效观察

摘要

Objective To investigate the role of positive end-expiratory pressure (PEEP) mechanical ventilation in the treatment of neurogenic pulmonary edema (NPE) after severe craniocerebral trauma (CCT). Methods 28 cases of severe CCT patients complicated with NPE were treated by conventional mechanical ventilation, and taken as control group. By applicating PEEP after the normal treatment, the treated group was compared to the control group in pulmonary rale, RR, PaO2 , SaO2 , PaCO2. Results 2 h after PEEP ventilation, moist rales in 26 patients decreased significantly or disappeared; RR, PaO2, SaO2 improved with a significant difference ( P ＜ O. 001 ). Conclusion Application of mechanical ventilation with PEEP to treat NPE after severe CCT can quickly and significantly increase PaO2. It is currently one of the most effective ways to treat NPE.%目的 探讨呼气末正压机械通气(positive end-expiratory pressure,PEEP)在救治重型颅脑损伤后神经源性肺水肿(neurogenic pulmonary edema,NPE)中的作用.方法 对28例重型颅脑损伤并发神经源性肺水肿患者进行常规机械通气,并设对照组;应用PEEP治疗后设置为治疗组,进行肺部啰音、RR、PaO2、SaO2、PaCO2比较.结果 PEEP治疗2 h后,26例患者双肺湿啰音明显减少甚至消失,RR、PaO2、SaO2改善具有极显著性差异( P <0.001).结论 机械通气加用PEEP治疗重型颅脑损伤后NPE能在短时间内明显提高PaO2,是目前治疗NPE最有效的方法之一.