机械通气辅助治疗在重症哮喘合并呼吸衰竭急诊抢救中的应用效果

Application effect of mechanical ventilation adjuvant therapy in emergency rescuing of respiratory failure complicated with severe asthma

目的探讨在重症哮喘合并呼吸衰竭患者的急诊抢救过程中应用机械通气进行辅助治疗的疗效。方法 70例重症哮喘合并呼吸衰竭患者,采用随机数字表法分为研究组和参照组,各35例。参照组采用常规治疗,研究组在常规治疗基础上联合机械通气治疗。观察两组患者的呼吸频率（RR）、心率（HR）、二氧化碳分压（PaCO_2）、血氧饱和度（SpO_2）、血氧分压（PaO_2）等指标及死亡情况。结果研究组RR、HR、PaCO_2、PaO_2、SpO_2分别为（26.5±4.2）次/min、（112.9±6.0）次/min、（57.3±8.6）mm Hg（1 mm Hg=0.133 k Pa）、（73.1±8.2）mm Hg、（0.83±0.02）;参照组RR、HR、PaCO_2、PaO_2、SpO_2分别为（31.3±4.9）次/min、（123.5±7.1）次/min、（63.1±8.9）mm Hg、（65.3±8.7）mm Hg、（0.81±0.02）;两组各项指标比较差异有统计学意义（P〈0.05）。研究组无死亡患者,参照组死亡4例,死亡率为11.43%,两组死亡率比较差异有统计学意义（χ~2=4.2424,P〈0.05）。结论重症哮喘合并呼吸衰竭患者病情危急,在常规治疗基础上给予机械通气治疗可以帮助患者稳定生命体征,提高救治成功率,降低药物使用量,对改善患者的预后有重要作用,值得重症哮喘合并呼吸衰竭患者选用。

Objective To observe clinical effect of mechanical ventilation adjuvant therapy in emergency rescuing of respiratory failure complicated with severe asthma. Methods A total of 70 respiratory failure combined severe asthma patients were divided by random number method into research group and control group, with 35 cases in each group. The control group received conventional therapy, and research group received mechanical ventilation adjuvant therapy on the basis of control group. Observation were made on respiratory rate（RR）, hear rate（HR）, partial pressure of carbon dioxide（PaCO_2）, oxyhemoglobin saturation（SpO_2）, partial pressure of blood oxygen（PaO_2）and deaths. Results The research group had RR, HR, PaCO_2, PaO_2 and SpO_2 respectively as（26.5±4.2）times/min,（112.9±6.0）times/min,（57.3±8.6）mm Hg（1 mm Hg=0.133 k Pa）,（73.1±8.2）mm Hg,（0.83±0.02）, and control group had RR, HR, PaCO_2, PaO_2 and SpO_2 respectively as（31.3± 4.9）times/min,（123.5±7.1）times/min,（63.1±8.9）mm Hg,（65.3±8.7）mm Hg,（0.81±0.02）, and all indexes had statistically significant differences between two groups（P〈0.05）. The research group no dead case, and control group had 4 dead cases, accounting for 11.43%, and mortality had statistically significant difference in two groups（χ2=4.2424, P〈0.05）. Conclusion Respiratory failure complicated with severe asthma patients were usually with critical condition, and mechanical ventilation adjuvant therapy on the basis of conventional therapy can help stabilize life sign, increase saving success rate, decrease drug use. This method also palys an important role in improving the prognosis of patients and worth selection of patients with respiratory failure complicated with severe asthma.