急性重症支气管哮喘并气胸无创通气治疗的临床评价  

Sequential treatment for patients of bronchial asthma accompanied by pneumothorax

作　　者：秦光梅[1] 江兵[1] 杨时光 刘俊霞[1] 

机构地区：[1]重庆市第二人民医院呼吸内科,永川402160

出　　处：《第三军医大学学报》2006年第8期854-856,共3页Journal of Third Military Medical University

摘　　要：目的对40例急性重症支气管哮喘并气胸患者的治疗情况进行观察以探讨无创通气在哮喘并气胸的疗效。方法按随机原则分为两组,治疗组22例,对照组18例,治疗组在胸腔闭式引流后采用双水平正压通气(bilevelpostiveairwaypressure,BiPAP),对照组仅作胸腔闭式引流与常规给氧。结果在上机24h后两组患者的PO2、SO2、PCO2、呼吸频率有显著差异(P<0.05),大部分患者避免了有创通气,同时未发现因双水平正压通气引起血压明显变化(P>0.05),治疗组治疗前后PO2、SO2、PCO2、呼吸频率、心率、血压有显著差异(P<0.05),未引起气胸压缩扩大。结论胸腔闭式引流后立即双水平正压通气治疗支气管哮喘并气胸在临床上是有效的,也是相对安全的。Objective To study the curative effect of noninvasive ventilation on the patients of acute serious.bronchial asthma complicated with pneumothorax. Methods Forty patients were randomly assigned to receive BiPAP ventilation immediately after thoracic closing drainage, or nasal catheter oxygen inhalation after thoracic closing drainage. Results After 24-hour ventilation, the levels of PO2, SO2, PCO2 and breath rate between two groups were of remarkable difference （ P 〈 0.05 ）, so most patients avoided invasive ventilation, meanwhile blood pressure of the patients undergoing BiPAP showed no significant change with that of control group （P 〉 0.05 ）. The level of PO2, SO2, PCO2, and heart rate, respiratory rate of the BiPAP patients were of remarkable difference （P 〈 0.05 ） before and 24 h after BiPAP ventilation. Conclusion It is effectual and safe to treat the patients of bronchial asthma accompanied by pneumothorax by BiPAP ventilation immediately after thoracic closing drainage.

关 键 词：支气管哮喘 气胸 胸腔闭式引流 双水平正压通气 

分 类 号：R459.7[医药卫生—急诊医学] R561.405[医药卫生—治疗学]