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目的评价无创性鼻(面)罩双水平气道正压通气(BiPAP)联合参麦注射液救治心源性肺水肿(ACPE)对N端脑钠肽前体(NT-proBNP)及Boston积分的影响。方法采用前瞻性研究方法选取ACPE患者120例,随机分为参麦组、BiPAP组、BiPAP+参麦组和对照组四组,分别采用常规治疗+参麦,常规治疗+BiPAP,常规治疗+参麦+BiPAP和常规治疗四种不同方法进行干预,观察周期为3 d。比较四组患者NT-proBNP、Boston积分、症状缓解时间、抢救成功率情况。结果治疗前四组患者NT-proBNP与Boston积分比较无显著差异(P>0.05),治疗后四组患者NT-proBNP与Boston积分均较治疗前明显改善(P<0.05),但同期比较BiPAP+参麦组改善效果最显著,明显优于对照组、参麦组及BiPAP组(P<0.05),参麦组及BiPAP组改善效果优于对照组(P<0.05),但参麦组与BiPAP组比较并无明显差异(P>0.05)。对照组症状缓解时间明显长于各组,抢救成功率明显低于各组(P<0.05);BiPAP+参麦组患者症状缓解时间明显短于其他组、抢救成功率明显高于其他组(P<0.05),参麦组与BiPAP组比较则无显著差异(P>0.05)。结论 BiPAP联合参麦注射液治疗心源性肺水肿可有效改善患者的NT-proBNP及Boston积分水平,且可提高ACPE抢救成功率、缩短缓解时间,值得临床推广应用。
Objective To evaluate the effect of BiPAP combined with Shenmai injection on N-terminal pro-brain natriuretic peptide (NT-proBNP) and Boston integral in patients with cardiogenic pulmonary edema (ACPE) influences. Methods A prospective study was conducted to select 120 patients with ACPE and randomly divided into four groups: Shenmai, BiPAP, BiPAP + Shenmai and control group. The patients were treated with conventional therapy + Shenmai, routine therapy + BiPAP, conventional therapy plus Shenmai + BiPAP and routine treatment of four different methods of intervention, the observation period of 3 d. Four groups of patients NT-proBNP, Boston points, symptom relief time, rescue success rate. Results There was no significant difference between NT-proBNP and Boston scores in the four groups before treatment (P> 0.05). NT-proBNP and Boston scores of the four groups were significantly improved after treatment (P <0.05), but compared with BiPAP + Mai Mai group and BiPAP group (P <0.05), Shen Mai group and BiPAP group improved better than the control group (P <0.05), but Shen Mai group and BiPAP group There was no significant difference (P> 0.05). The symptom relief time in the control group was significantly longer than that in each group, and the success rate of rescue was significantly lower than that in each group (P <0.05). The symptom relief time in BiPAP + Shenmai group was significantly shorter than that in other groups, and the rescue success rate was significantly higher ), There was no significant difference between Shen Mai group and BiPAP group (P> 0.05). Conclusion The combination of BiPAP and Shenmai injection in the treatment of cardiogenic pulmonary edema can effectively improve the level of NT-proBNP and Boston, and can improve the success rate of ACPE rescue and shorten the remission time, which is worthy of clinical application.