大剂量皮质激素联合BiPAP呼吸机辅助治疗重症哮喘患者的疗效观察

目的探讨大剂量皮质激素联合BiPAP呼吸机辅助治疗重症哮喘患者的疗效。方法将自2007年6月至2010年6月收治的50例重症哮喘的患者,随机分为观察组和对照组,每组25例,两组均在常规治疗的基础上采用BiPAP呼吸机辅助治疗,其中对照组采用甲泼尼龙1.5mg/(kg·d),观察组采用甲泼尼龙3.0mg/(kg·d)治疗,比较患者的临床疗效、治疗前后主要临床症状的变化及48h后的心率、呼吸频率、动脉血氧分压及动脉血氧饱和度。结果观察组显效17例,有效6例,总有效率为92.0%(23/25),显著高于对照组的80.0%(20/25),P<0.05。两组患者治疗后48h的心率、呼吸频率、动脉血氧分压及动脉血氧饱和度均较治疗前有明显改善,P<0.05。但观察组的改善效果显著优于对照组,且观察组患者的气道痉挛、呼吸困难、紫绀及肺
音等临床症状较对照组显著改善(P<0.05)。结论大剂量皮质激素联合BiPAP呼吸机辅助治疗重症哮喘可改善患者肺的氧合功能,改善呼吸困难,效果确切,值得临床推广。

Objective To investigate high dose corticosteroids combined BiPAP ventilator assisted treatment of severe asthma patients.Methods From June 2007 to June 2010,50 patients were admitted with severe asthma were randomly divided into two groups and the control group,n = 25 in both groups were the basis of routine treatment with BiPAP breathing machine adjuvant therapy,in which the control group using methylprednisolone 1.5mg/（kg＊d）,the observation group with methylprednisolone 3.0mg（kg·d）,treatment,clinical efficacy compared before and after treatment,and the major changes in clinical symptoms After 48h the heart rate,respiratory rate,blood pressure and blood oxygen saturation.Results The observation group 17 cases markedly effective in 6 cases,total effective rate was 92.0%（23/25） was significantly higher than the 80.0%（20/25）,P0.05.48h after treatment,two groups of patients the heart rate,respiratory rate,blood pressure and arterial oxygen saturation significantly improved compared with before treatment,P0.05.However,the improvement effect of the observation group were significantly better than the control group,and the observed group of patients with airway spasm,dyspnea,cyanosis and pulmonary rales and other clinical symptoms improved significantly compared with the control group,P0.05.Conclusion High dose corticosteroid therapy combined BiPAP ventilator-assisted patients with severe asthma may improve lung oxygenation,improve breathing difficulties,the exact effect and is worthy of promotion.