双水平气道正压通气治疗重度哮喘的临床评价

目的对双水平气道正压通气在重度哮喘治疗中的作用进行分析和评价。方法通过70例重度哮喘患者的回顾性分析研究，根据患者所接受的治疗方式分为无创通气组和对照组。对照组31例，接受吸氧以及抗生素、化痰药物、支气管扩张剂等常规治疗方法；无创通气组39例，除给予对照组患者相同常规治疗外，给予BiPAP无创通气治疗。观察患者的心率、呼吸频率和血气分析的改变情况。结果治疗前两组患者各项指标差异无统计学意义（P〉0．05），治疗12h后，无创通气组患者的PaO2、HR、PR明显好转（P〈0．05），并且随着治疗时间的增加而得到进一步改善；对照组患者在治疗12h后，各项指标改善尚不明显（P〉0．05），直到治疗72h才出现明显好转（P〈0．05）。治疗12h后，无创通气组与对照组比较，前者PaO2、HR、PR的变化明显（P〈0．05）；治疗72h无创通气组与对照组比较各指标改善更明显（P〈0．05）。结论联合运用BiPAP无创通气较常规治疗能快速改善患者的缺氧状态、缩短哮喘缓解时间，在重度哮喘的治疗中有积极作用。

Objective To study the effect of Bi - level positive airway pressure ventilation （BiPAP） in severe asthma. Methods In the retrospective study 70 patients with severe asthma were enrolled, from Jun 2001 to Aug 2010,who were divided into noninvasive ventilation group and control group according the ways of treatment. The control group accepted routine treatment such as oxygen, antibiotics and bronchodilators. The noninvasive ventilation group were given additional Bi - level positive airway pressure ventilation on. The changes of. PH, PaO2 , PaCO2 in arterial blood gas and the changes of. HR, RR were observed. Results Before treatment, the two groups showed no significant difference （P 〉 0. 05 ）. After 12h formal treatment, the indicators of HR, RR and PaO2 of noninvasive ventilation group were obviously improved （ P 〈 0. 05 ）. The further treatment, the higher improvement. The control group after 12h treatment, each index was not enhanced obviously. （P 〉 0. 05）. The control group did not appear significant improvement until 72h treatment （P 〈 0. 05 ）. Compared with the control group, the indicators of HR, RR and PaO2 change remarkably after 12h treatment. Each index of noninvasive ventilation changes obviously after72h treatment. Conclusion Compared with conventional treatmen,the combinated use of BiPAP can improve the patient＇s hypoxia rapidly and short time to recur, so BiPAP has certain effect, for patients with severe asthma.