支气管肺泡冲洗联合无创通气治疗重症哮喘的疗效评价

Application of bronchoalveolar lavage plus non - invasive pressure ventilation in management of patients with severe asthma

目的 探讨支气管肺泡冲洗联合无创通气对常规治疗失败的重症哮喘的应用价值。方法 选择常规治疗失败的重症哮喘患者41例，随机分为两组：对照组和冲洗组。对照组给予常规基础治疗及无创通气治疗，冲洗组在对照组治疗的同时给予支气管肺泡冲洗。结果 冲洗组气管插管率、症状改善时间及ICU住院天数较对照组低（P〈0．05），第1秒钟用力呼气容积占预计值百分比、用力肺活量占预计值百分比、吸气相气道正压、PaO2、PaCO2的改善情况均优于对照组。结论 支气管肺泡冲洗联合无创通气应用于常规治疗失败的重症哮喘可以改善血气及肺功能，并且降低气管插管率及缩短ICU住院天数。

Objective To study the practical applications of using bronchoalveolar lavage in combination with non - invasive positive - pressure ventilation treating severe asthma patients who failed of success on regular asthma therapeutic methods. Methods Forty - one patients were divided randomly into two groups： control group and bronchoalveolar lavnge group. Control group received base and noninvasive positive - pressure ventilation therapy, bronchoalveolar lavage group received therapy combined base and non - invasive positive - pressure ventilation with bronchoalveolar lavnge. Results In bronchoalveolar lavage group, intubation rate, symptom - recovering time and ICU - clay were significantly lower than those in control group（ P 〈 0.05 ）, the melioration of pulmonary function （ FEV1 and FVC ）, PaO2, PaCO2 and IPAP were better than those in control group（P 〈 0.05）. Conclusion Bronchoalveolar layage combined with non - invasive positive - pressure ventilation treating severe asthma who fail of success on regular therapy can improve pulmonary function and decrease PaCO2, tracheointubation rate and ICU - day.