重症哮喘合并呼吸衰竭的急诊治疗效果及抢救成功率和死亡率评价

Emergency treatment and evaluation of the success rate and mortality rate of severe asthmatic patients with respiratory failure

目的对重症哮喘合并呼吸衰竭的急诊治疗效果及抢救成功率和死亡率进行评价。方法选择本院在2016年3月～2018年3月间收治的92例诊断为重症哮喘合并呼吸衰竭的患者作为研究对象,根据采用的急救措施分为对照组(n=46)和呼吸机组(n=46),对照组患者根据临床症状进行对症治疗,呼吸机组在对照组基础上应用无创呼吸机进行通气治疗,对两组患者治疗效果、抢救成功率和死亡率进行评价对比。结果两组患者治疗前心压(HR)、pH、血氧分压(PaO_2)和二氧化碳分压(PaCO_2)水平均没有明显差异,P> 0.05;治疗后两组患者生命指标较治前均明显改善,P <0.05;治疗后呼吸机组患者以上各项指标水平均明显优于对照组,差异明显,P <0.05。呼吸机组患者抢救成功率为93.48%,明显高于对照组的65.22%,P <0.05;呼吸机组包括46例患者,死亡率为0,对照组组患者死亡率为8.69%,呼吸机组患者死亡率明显低于对照组,P <0.05。结论在重症哮喘合并呼吸衰竭的急诊抢救过程中联合应用呼吸机无创正压通气,临床治疗效果显著,抢救成功率明显提高,具有较高的临床应用意义。

Objective To evaluate the efficacy of emergency treatment of severe asthma with respiratory failure and the success rate of rescue and mortality. Methods 92 patients diagnosed as severe asthma combined with respiratory failure were treated in the hospital from March 2016 to March 2018. According to the first aid measures, they were divided into the control group（n=46） and the respiratory unit group（n=46）. The patients in the control group were given symptomatic treatment. The patients in respiratory unit group were given noninvasive ventilator treatment on the basis of the treatment of the control group. The therapeutic efficacy,rescue success rate and mortality rate of the two groups were compared. Results There were no significant differences in HR,PH,PaO2 and PaCO2 levels between the two groups before treatment,P〈0.05,and the life indexes of two groups were significantly improved after treatment,P〈0.05. After treatment,the levels of the respiratory unit group were obviously better than those in the control group,and the difference was obvious,P〈0.05. The success rate of patients with respiratory unit was 93.48%,which was significantly higher than that in the control group. The mortality rate of the respiratory unit group was 0,which was 8.69% in the control group. This was significantly lower,P〈0.05. Conclusion In the emergency rescue of severe asthma combined with respiratory failure,the combined application of noninvasive positive pressure ventilation has a significant effect. The success rate of rescue is obviously improved. It has higher clinical application significance.