无创正压通气治疗小儿哮喘持续状态的疗效观察

Clinical observation of CPAP in treating pediatric asthma sustaining state

目的探讨小儿哮喘持续状态应用无创正压通气(CPAP)治疗后临床症状的改善情况以及小儿哮喘持续状态应用CPAP的临床价值。方法选取2004—2009年开封市第一人民医院小儿哮喘持续状态患者57例,男32例,女25例。其中,26例(男15例,女11例)随机应用无创呼吸机辅助治疗为治疗组,CPAP应用S/T模式。余31例(男17例,女14例)为对照组,均采取了抗感染平喘抗过敏等药物治疗,组间差异无显著性。结果应用无创正压通气(CPAP)治疗的哮喘持续状态的患儿,在喘息状态缓解时间,肺部听诊双肺不能闻及哮鸣音或可闻及少量哮鸣音、三凹征缓解、呼吸下降至30次/分以下、心率下降至120次/分以下等各项指标缓解时间上,明显优于对照组。结论无创呼吸机辅助治疗小儿哮喘持续状态,可以改善换气功能并减少呼吸肌疲劳做功,是辅助治疗哮喘的有效方法,值得推广。

Objective To discuss the clinical improvement of children with status asthmaticus after using noninvasive positive pressure ventilation（CPAP） and to evaluate the clinical effects of CPAP applied to children with status asthmaticus.Methods Fifty-seven children with status asthmaticus（32 male,25 female） from 2004 to 2009 were randomly divided into two groups,the therapy group of 26 cases（15 male and 11 female） and the control group of 31 cases（17 male and 14 female）.The noninvasive ventilator was applied to the therapy group as auxiliary treatment,and S/T Mode was used.The control group were treated with medication such as anti-infective agents,dyspnea-relieving drugs and anti-allergic drugs.There was no significant difference between the two groups.Results The symptoms of the therapy group were obviously improved than that of the control group.To the therapy group,in the asthma-relieving period,a little or even no wheeze in the lungs could be heard;the three-depression sign was relieved;the respiratory rate dropped to around 30 times per minute,and the heart rate dropped to below 120 beats per minute.Conclusions The noninvasive ventilator,which can improve the ventilation function and relieve the respiratory muscle fatigue,is an effective auxiliary treatment to status asthmaticus in children,and worth popularizing.