无创正压通气加气道给药治疗重症哮喘的临床研究  

Clinical study on severe asthma treated by noninvasive positive pressure ventilation combined with trachea medication

作　　者：邵闳[1] 鲍俊晰[1] 杨会英[1] 王丽[1] 王锋[1] 孙磊[1] 杨秀娜[1] 

机构地区：[1]石家庄市第三医院呼吸科,050011

出　　处：《疑难病杂志》2007年第9期524-526,共3页Chinese Journal of Difficult and Complicated Cases

基　　金：河北省科技研究与发展计划项目(No.052761386)

摘　　要：目的探讨无创正压通气(NIPPV)加气道给药治疗重症哮喘的疗效及安全性。方法125例重症哮喘患者随机分为双水平气道正压通气(BiPAP)呼吸机治疗组(观察组,n=63)及常规治疗组(对照组,n=62),观察组常规治疗加用BiPAP,呼吸机经口鼻面罩进行NIPPV并加气道给药。对照组仅做常规治疗,比较2组患者治疗前后的临床表现、部分动脉血气、肺功能的变化。结果观察组患者症状迅速缓解,治疗4h、24h后血压、心率、呼吸均有明显改善(P<0.05),治疗24h后pH值、PaCO2及FEV1%、PEF均有明显升高(P<0.05)。观察组总有效率为96.8%,明显高于对照组的77.4%;观察组平均住院天数为(10±6)d,明显短于对照组的(17±6)d,差异均有统计学意义(P<0.05)。结论NIP-PV加气道给药治疗重症哮喘疗效较快捷、明显,减少了使用有创呼吸机的概率并缩短了患者住院时间。Objective To investigate the therapeutic effect and safety of noninvasive positive pressure ventilation （NIPPV） combined with trachea medication on severe asthma. Methods 125 patients with severe asthma were divided into two groups. 63 patients in observation group, on the basis of routine therapy, were treated by BiPAP and noninvasive positive pressure ventilation combined with trachea medication; the other 62 patients in control group were treated only by routine therapy .The clinical symptoms, blood gas and pulmonary function in partial arteries before and after treatment were observed and compared between the two groups. Results The patients＇ clinical symptoms were obviously relieved in observation group. The blood pressure, heart rate and respiration were obviously improved 4 h and 24 h after treatment, as compared with those in control group （ P 〈 0.05）, and pH, PaCO2, FEV1 % and PEF in observation group 24 h after treatment were significantly increased （ P 〈 0.05）. The total effective rate （96.8%） in observation group was significantly higher than that （77.4%） in control group（ P 〈 0.05）. The mean hospitalization time （ 10 ± 6）d in observation group was significantly shorter than that （ 17 ± 6）d in control group（ P 〈 0.05）. Con- clusion The application of NIPPV combined with trachea medication in the treatment of severe asthma could improve clinical symptoms obviously and quickly, and could reduce the possibility of using invasive breathing machine, and couht shorten the hospitalization time of patients.

关 键 词：无创正压通气 重症哮喘 气道给药 

分 类 号：R562.25[医药卫生—呼吸系统] R605.973[医药卫生—内科学]