SIMV与PSV治疗重症哮喘的疗效观察

Effectiveness Observation of SIMV and PSV in Treatment of Severe Asthma

目的:探讨SIMV+PSV机械通气方式治疗重症哮喘的疗效。方法:在纤维支气管镜引导下经鼻气管插管建立人工气道,使用德国产drger呼吸机,采用SIMV+PSV通气方式,治疗重症哮喘患者5例,并比较治疗前后血气分析及神志、肺部体征的变化。结果:5例患者经治疗后均神志变清,肺部哮鸣音消失,血气分析指标均恢复至正常。结论:SIMV+PSV通气方式对重症哮喘患者治疗效果肯定,对于临床经保守治疗后症状不改善反而出现呼吸困难、神志改变的患者应尽早实施机械通气治疗。其与PEEP方式比较,因其没有气压损伤及对循环系统的不良影响,且更接近于生理性通气而更易为患者所接受。

Objective： To explore the curative effect of mechanical ventilation of synchronized intermittent mandatory ventilation（SIMV） and pressure support ventilation（PSV） in treatment of patients with severe asthma. Methods：Five patients with severe asthma were treated with SIMV and PSV of PN-2000 type ventilator, which was led by branchofiberscope and pernasal endotracheal intubation to establish an artificial airway, and the changes of blood gas analysis, consciousness and physical signs in lungs before and after treatment were compared. Results：After treatment, their consciousness regained , wheezes of bronchi disappeared and the index of blood gas analysis became normal. Conclusions： Curative effect of SIMV and PSV therapy is affirmative for the patients with severe asthma. The patients should be treated with mechanical ventilation as soon as possible if the symptom is not ameliorated with conservative therapy in clinics instead of dyspnea, and disturbance of consciousness. Compared with positive end- expiratory pressure（PEEP）therapy, the patients will easily accept the therapy of synchronized intermittent mandatory ventilation（SIMV） and pressure support ventilation（PSV）, because there is no damage of gas pressure, adverse effects to circulatory system but more close to physiological ventilation.