中国医学创新2025，Vol.22Issue(10)：14-18,5.DOI:10.3969/j.issn.1674-4985.2025.10.004
高PEEP有创机械通气联合密闭式吸痰术在急性心源性肺水肿患者中的应用效果
Application Effect of Invasive Mechanical Ventilation with High PEEP Combined with Closed Sputum Aspiration in Patients with Acute Cardiogenic Pulmonary Edema
摘要
Abstract
Objective:To investigate the the application effect of invasive mechanical ventilation with high positive end expiratory pressure(PEEP)combined with closed sputum aspiration in patients with acute cardiogenic pulmonary edema.Method:A total of 160 patients with acute cardiogenic pulmonary edema underwent invasive mechanical ventilation treated in the First People's Hospital of Qinzhou from May 2022 to June 2024 were divided into group A(given high PEEP combined with closed sputum aspiration),group B(given high PEEP combined with open sputum aspiration),group C(given low PEEP combined with closed sputum aspiration)and group D(given low PEEP combined with open sputum aspiration)according to the random number table method,with 40 cases in each group.The total effective rate,mechanical ventilation time,hospitalization time,treatment cost,complication rate,pulmonary function[compliance of pulmonary artery(Cdyn),respiratory system resistance(Rrs)and airway occlusion pressure(P0.1)],myocardial enzymes[creatine kinase(CK)and creatine kinase isoenzyme(CK-MB)],extravascular lung water index(EVLWI),and pulmonary vascular permeability index(PVPI)were compared among the four groups.Result:The total effective rate of group A and group B were significantly higher than those of group C and group D,the mechanical ventilation time and hospitalization time of group A were significantly shorter than those of group B,group C and group D,the treatment cost was significantly less than that of group B,group C and group D,and the complication rate was significantly lower than that of group B,group C,and group D,the differences were statistically significant(P<0.05).There were no statistically significant differences in pulmonary function,myocardial enzymes,EVLWI and PVPI among the four groups before treatment(P>0.05).After 1 and 2 d of treatment,Cdyn in group A were significantly higher than those in group B,group C and group D,and Rrs and P0.1 were significantly lower than those in group B,group C and group D,the differences were statistically significant(P<0.05).After 2 days of treatment,the myocardial enzyme indexes in group A were significantly lower than those in group B,group C,and group D,and those in group B were significantly lower than those in group C and group D,the differences were statistically significant(P<0.05).Conclusion:The application of invasive mechanical ventilation with high PEEP combined with closed sputum aspiration in acute cardiogenic pulmonary edema has a good effect,which can significantly improve the pulmonary function of patients,reduce the complication rate,and promote recovery.关键词
呼气末正压通气/有创机械通气/密闭式吸痰术/急性心源性肺水肿/血管外肺水指数Key words
Positive end expiratory pressure/Invasive mechanical ventilation/Closed sputum aspiration/Acute cardiogenic pulmonary edema/Extravascular lung water index引用本文复制引用
梁德金,刘秋英,覃凤兰,黄平芳,何秋娟..高PEEP有创机械通气联合密闭式吸痰术在急性心源性肺水肿患者中的应用效果[J].中国医学创新,2025,22(10):14-18,5.基金项目
广西壮族自治区卫生健康委员会自筹经费科研课题(Z-N20221874) （Z-N20221874）
