无创通气治疗急性重症支气管哮喘的效果研究

Study on the effect of noninvasive ventilation in the treatment of acute severe bronchial asthma

目的研究无创通气治疗急性重症支气管哮喘的效果。方法抽选2014年7月-2015年7月就诊于我院的急性重症支气管哮喘患者106例,随机法分为通气组和常规组,每组各53例。常规组给予吸氧、雾化吸入、抗炎止咳、化痰止喘、维持体液平衡等常规治疗,通气组在上述治疗基础上给予无创通气治疗。比较两组患者临床疗效,记录治疗前、治疗1 d及治疗后血心率、呼吸、血气指标(血氧分压、血二氧化碳分压)水平。结果通气组总有效率与常规组比较显著较高(94.34%vs 81.13%),差异有统计学意义(χ2=4.296,P<0.05)。两组患者治疗1 d及治疗后心率、呼吸、血氧分压、血二氧化碳分压水平均显著改善,差异有统计学意义(均P<0.05)。治疗后通气组心率、呼吸、血二氧化碳分压水平低于常规组〔(80.0±2.2)次/min、(18.6±3.5)次/min、(37.3±12.7)mm Hg vs(91.6±4.3)次/min、(24.6±5.1)次/min、(42.7±13.9)mm Hg〕,血氧分压高于常规组〔(103.1±9.4)mm Hg vs(84.7±9.3)mm Hg〕,差异有统计学意义(P<0.05)。通气组住院时间与常规组比较较短〔(13.3±5.8)d vs(18.6±7.4)d〕,差异有统计学意义(P<0.05)。结论无创通气治疗急性重症支气管哮喘能迅速改善患者呼吸、心率、血气指标水平,缩短住院时间,临床疗效显著。

Objective To study the effects of noninvasive ventilation in the treatment of acute severe bronchial asthma. Methods 106 patients with acute severe bronchial asthma who were treated in our hospital between July 2014 and July2015 were selected and randomly divided into the ventilation group and the routine group,53 cases in each group. The routine group was given oxygen inhalation,aerosol inhalation,anti- inflammatory and antitussive therapy,expectorant and Zhichuan therapy,maintenance of body fluid balance and other conventional therapies. The ventilation group,on the basis of the above treatment,was given noninvasive ventilation therapy. The clinical curative effect was compared between the two groups. The blood heart rate,respiratory and blood gas indexes（ blood oxygen pressure,blood partial pressure of carbon dioxide） levels were recorded before treatment,after 1d of treatment and after treatment. Results The total effective rate in the ventilation group was significantly higher than that in the control group（ 94. 34% vs 81. 13%）（ P〈0. 05）. After 1d of treatment and after treatment,heart rate,respiration,blood oxygen pressure and blood partial pressure of carbon dioxide levels in the two groups were improved significantly（ P〈0. 05）. After treatment,heart rate,respiration and blood partial pressure of carbon dioxide levels in the ventilation group were lower than those in the routine group [（ 80. 0 ± 2. 2）times / min,（ 18. 6 ± 3. 5） times / min,（ 37. 3 ± 12. 7） mm Hg vs（ 91. 6 ± 4. 3） times / min,（ 24. 6 ± 5. 1） times / min,（ 42. 7 ± 13. 9） mm Hg]while blood oxygen pressure was higher than that in the routine group [（ 103. 1 ± 9. 4） mm Hg vs（ 84. 7 ± 9. 3） mm Hg]（ P〈0. 05）. The hospitalization time of the ventilation group was significantly shorter than that of the control group[（ 13. 3 ± 5. 8） d vs（ 18. 6 ± 7. 4） d]（ P〈0. 05）. Conclusion Noninvasive ventilation in the treatment of acute severe bronchial asthma can rapidly improve respiration,heart rate and blood gas indexes levels and shorten the hospitalization time. The clinical curative effect is significant.