高海拔地区无创正压通气在治疗重症哮喘中的临床应用研究  

Clinical effects of noninvasive positive pressure ventilation on severe bronchial asthma patients with respiratory failure in high altitude region

作　　者：周红梅 刘丽华 巩增锋[2] 刘雯 柳小平 薛喜锐 马宝义 张红国[4] 孙炳华[5] 马俊婷 付伟红 唐天红 许娟 张文进 

机构地区：[1]甘肃省第二人民医院,甘肃兰州730000 [2]酒钢集团兰泰医院 [3]临夏回族自治州医院 [4]嘉峪关市人民医院 [5]张掖市人民医院 [6]兰州市肺科医院

出　　处：《西北国防医学杂志》2011年第5期330-332,共3页Medical Journal of National Defending Forces in Northwest China

基　　金：甘肃省自然科学基金资助项目(1010RJZA159)

摘　　要：目的:探讨无创正压通气(NPPV)在高海拔地区治疗重症支气管哮喘的有效及安全性。方法:68例重症支气管哮喘患者随机分为治疗组(NPPV组)37例,对照组(non-NPPV组)31例;治疗组在常规治疗基础上加NPPV,对照组常规治疗。结果:治疗2 d后两组患者的呼吸频率(RR)、心率(HR)、动脉血pH、PaO2、PaC02、SaO2均有明显改善(P<0.01);治疗组在治疗24 h和3 d后pH、PaO2、PaC02、SaO2改善优于对照组(P<0.01),住院天数、插管率及死亡率明显低于对照组(P<0.01)。结论:高海拔地区重症支气管哮喘在常规治疗基础上加NPPV治疗可有效改善症状,纠正缺氧,减少气管插管率,降低病死率,缩短住院时间及降低住院费用。Objective ：To evaluate the effect and safety of noninvasive positive pressure ventilation （NPPV） on severe bronchial asthma patients with respiratory failure in high altitude region. Methods： Sixty - eight patients were randomly divided into two groups ： the NPPV group received NPPV on the base of routine treatment （ NPPV group, n = 37 ） ; the non - NPPV group only received the routine treatment （ non - NPPV group, n = 31 ）. Results：Symptom of all patients was alleviated after 2 days treatment. But improvements of pH, PaO2, PaCO2 and SaO2 in NPPV group were more rapid and significant than non - NPPV group at 24 h,72 h （P 〈0.01 ）. The length of hospital stay, the rate of intubation and mortality of NPPV group were significantly lower than non - NPPV group （ P 〈 0.01 ）. Conclusion： Using NPPV based on routine treatment can improve the clinical manifestation and venti- lation, and raise the curative effects of severe asthma in high altitude region.

关 键 词：重症支气管哮喘 高海拔地区 无创正压通气 呼衰 

分 类 号：R562.25[医药卫生—呼吸系统]