目的　探讨重症急性心源性肺水肿的早期有创机械通气的疗效。方法　 2 5例重症急性心源性肺水肿患者进行早期有创机械通气 ,记录血氧的改善 ,心率、呼吸频率的变化及不良反应的发生率。结果　在通气后半小时低氧血症已明显改善 ,心率明显下降。在机械通气期间无一例死亡 ,所有病例均能在短时间内成功脱机 ,严重的心律失常、气压伤、呼吸机相关性肺炎发生率低。结论　对重症急性心源性肺水肿的患者 ,早期应用有创机械通气治疗是一种更为积极主动的治疗手段 ,能显著降低心室纤颤、心跳骤停、窒息等严重并发症的发生率。 Objective To investigate the effect of early invasive mechanical ventilation on severe acute cardiogenic pulmonary edema. Methods Twenty-five patients with severe acute cardiogenic pulmonary edema underwent invasive mechanical ventilation. The changes of blood oxygen, heart rate, respiratory rate and the incidence of adverse reactions were recorded. Results half an hour after ventilation hypoxemia has been significantly improved, heart rate decreased significantly. During the period of mechanical ventilation, none of the patients died. All cases were successfully taken offline in a short period of time. Serious arrhythmia, barotrauma and ventilator-associated pneumonia were low. Conclusions In patients with severe acute cardiogenic pulmonary edema, early application of invasive mechanical ventilation is a more aggressive treatment and can significantly reduce the incidence of serious complications such as ventricular fibrillation, cardiac arrest and asphyxia.