无创正压通气并经管道雾化吸入可必特治疗重症支气管哮喘的临床研究

The Clinical Research on Non-invasive Positive Pressure Ventilation Jointed Atomization Inhalation of Combivent Treated Severe Bronchial Asthma

目的:探讨无创正压通气并经管道雾化吸入可必特治疗重症支气管哮喘的疗效。方法:选择2011年6月-2013年1月在广东省农垦中心医院呼吸内科住院的重症支气管哮喘患者90例,随机分为治疗组和对照组,每组45例。对照组:予吸氧、抗感染、激素、解痉、平喘及化痰等常规治疗。治疗组:在常规治疗的基础上,同时应用经鼻(面)罩无创正压通气并经管道雾化吸入可必特治疗。观察两组患者的临床疗效,并记录两组患者治疗前及治疗6 h后其呼吸频率、血气分析指标的变化。结果:治疗组有效率明显高于对照组,差异有统计学意义(P<0.001);两组患者在治疗前的呼吸频率、血气分析指标等差异无统计学意义(P>0.05),治疗6 h后治疗组较对照组呼吸频率、动脉二氧化碳分压(PaCO2)降低,动脉血氧分压(PaO2)及血氧饱和度(SaO2)提高,差异均有统计学意义(P<0.05)。结论:无创正压通气并经管道雾化吸入可必特能有效治疗重症支气管哮喘,值得临床推广和应用。

Objective：To explore the clinical curative effect that non-invasive positive pressure ventilation jointed atomization inhalation of combivent treated severe bronchial asthma.Method：90 patients were randomly divided into treatment group and control group,which had been diagnosed as severe bronchial asthma in the Respiration Department of our hospital from June 2011 to January 2013. Each group contained 45 patients. The methods of treatment in control group were routine treatments,such as using oxygen,anti-infection,glucocorticoid,spasmolysis,relieving asthma and reducing phlegm. Excepting the routine treatments,treatment group also added non-invasive positive pressure ventilation jointed atomization inhalation of combivent. we observed the clinical effects in two groups. In addition,we recorded the changes of respiratory rate and the indexes of blood gas analysis before the therapy and after 6 hours of the therapy.Result：The effective rate in the treatment group was significantly higher than in the control group（P0.05）. However,after 6 hours of the therapy,respiratory rate and PaCO2 in treatment group were significantly lower compared to control group（P〈0.05）. On the contrary,PaO2 and SaO2 were significantly higher in treatment group （P〈0.05）.Conclusion：Non-invasive positive pressure ventilation jointed atomization inhalation of combivent have an obviously positive effect in the therapy of severe bronchial asthma,and need further promotion and application in the clinical work.