无创正压通气治疗哮喘急性发作患者的疗效探讨  

Investigating of the efficacy of noninvasive positive pressure ventilation in mild,moderate and severe patients with asthma exacerbations

作　　者：蒋敏[1] 刘昌秀[1] 梁子敬[1] 晏平[1] 陈少英[1] 吴淑金[1] 

机构地区：[1]广州医科大学第一附属医院,广东广州510120

出　　处：《西部医学》2015年第8期1190-1192,1195,共4页Medical Journal of West China

基　　金：广东省医学科研基金(A2012120)

摘　　要：目的探讨对哮喘急性发作患者使用无创正压通气(NPPV)的临床疗效和轻重分级之间的疗效差异。方法对160例符合诊断标准的支气管哮喘急性发作患者,按分类随机抽样法分为实验组和对照组,每组各80例,在解痉、平喘及抗炎等常规治疗基础上,实验组给予NPPV辅助治疗,对照组给予双腔鼻导管低中流量吸氧,使用多导生理监护仪持续对呼吸频率(RR)、心率(HR)和血氧饱和度(SaO2)进行监测,并分别在通气前和通气后抽动脉血测动脉血氧分压(PaO2)与二氧化碳分压(PaCO2)。实验组与对照组治疗前后的临床症状改善差异明显,临床指标(如呼吸频率、心率、PaO2及PaCO2等)、及住院时间比较差异具有统计学意义(P<0.05);实验组中轻度组与重度组治疗前后PaCO2、PaO2的比较,差异具有统计学意义(P<0.05)。结论 NPPV能迅速改善哮喘急性发作时的缺氧状态、减轻呼吸肌疲劳、明显缓解临床症状,轻、中度患者较重度患者耐受性好,且疗效更为显著。Objective To investigate clinical curative effects of noninvasive positive pressure ventilation （NPPV） and the differences of efficacy in mild, moderate and severe patients with acute attack of bronchial asthma. Methods 160 patients with asthma exacerbations were randomly classified into the experimental group and control group, 80 cases in each group. On the basis of anti-infection, relieving asthma, hormone and other conventional treatment, NPPV was given to the experimental group and the control group received the double-lumen low flow oxygen nasal cannula. The multi-pa- rameter monitor, continuous monitoring of respiratory rate（RR）, heart rate（HR）, and oxygen saturation（SaO2 ）was taken. The arterial partial pressure of oxygen in arterial blood （PaO2） and carbon dioxide partial pressure （PaCO2） were measured. Results Before and after the treatment, the clinical symptoms improved significantly different. The clinical indicators （such as respiratory rate, heart rate, PaO2 and PaCO2, etc. ）, and the hospital stay had significant difference between the experimental group and the control group （P〈0.05）. In experimental group, PaCO2, PaO2 of the mild, moderate and severe group had difference （P〈0. 05）. Conclusion NPPV could rapidly improve the state of hypoxia, acute asthma respiratory muscle fatigue and clinical symptoms of patients. The patients with mild to moderate compared with severe patients has good tolerance, and there are obviously curative effects.

关 键 词：支气管哮喘 急性发作 无创正压通气 治疗作用 

分 类 号：R562.25[医药卫生—呼吸系统]