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目的评价参麦注射液联合持续气道正压通气(CPAP)、双水平气道正压通气(Bi PAP)治疗急性心源性肺水肿(ACPE)的疗效和安全性。方法 53例经常规治疗30 min无效的ACPE患者,随机分为CPAP组(n=26)和Bi PAP组(n=27)。CPAP组在常规治疗基础上辅助CPAP和参麦注射液治疗;Bi PAP组辅助Bi PAP和参麦注射液治疗。治疗2 h后,比较2组患者的临床有效率、氧分压(Pa O2)、氧合指数(Pa CO2/Fi O2)等血气分析指标、心率(HR)、呼吸频率(RR)、平均动脉压(MAP)、视觉模拟评分(VAS)和不良反应发生率。结果 CPAP组和Bi PAP组患者临床有效率分别为84.6%和81.5%,差异无统计学意义(P>0.05);2组患者HR、RR及MAP均较治疗前显著下降(均P<0.05);Pa O2及Pa O2/Fi O2较治疗前明显升高(均P<0.05),但2组间比较差异无统计学意义(均P>0.05);Bi PAP组患者VAS值显著低于CPAP组(P<0.05)。2组患者不良反应均较少,且差异无统计学意义(P>0.05)。结论参麦注射液联合CPAP或Bi PAP对ACPE患者疗效确切,安全可靠。
Objective To evaluate the efficacy and safety of Shenmai injection combined with continuous positive airway pressure (CPAP) and bi-level positive airway pressure (Bi PAP) in the treatment of acute cardiogenic pulmonary edema (ACPE). Methods Fifty-three patients with ACPE who had been treated for 30 min after conventional therapy were randomly divided into CPAP group (n = 26) and Bi PAP group (n = 27). CPAP group assisted CPAP and Shenmai injection on the basis of routine treatment; Bi PAP group assisted Bi PAP and Shenmai injection. After 2 hours of treatment, the clinical efficiency, Pa O2, Pa CO2 / Fi O2 and other blood gas analysis indicators, heart rate (HR), respiratory rate (RR), mean arterial pressure Pressure (MAP), visual analogue scale (VAS) and incidence of adverse reactions. Results The clinical effective rates of CPAP group and Bi PAP group were 84.6% and 81.5% respectively, with no significant difference (P> 0.05). The HR, RR and MAP of the two groups were significantly lower than those before treatment (all P <0.05) ; Pa O2 and Pa O2 / Fi O2 were significantly higher than those before treatment (all P <0.05), but there was no significant difference between the two groups (all P> 0.05); VAS values in Bi PAP group were significantly lower than those in CPAP group (P <0.05). Adverse reactions in both groups were less, and the difference was not statistically significant (P> 0.05). Conclusion Shenmai injection combined with CPAP or Bi PAP is effective and safe for ACPE patients.