重度支气管哮喘急性发作期患者应用BiPAP通气治疗的实践与评估

Practice and evaluation of BiPAP ventilation in patients with severe bronchial asthma during acute attack

目的探讨采用口鼻面罩的双水平正压通气(Bi PAP)治疗重度支气管哮喘急性发作期患者的临床实践与评估。方法选取2017年10~12月本院就诊并诊断为重度支气管哮喘急性发作期患者88例为研究对象,采用随机数字表法分成实验组和参照组,每组各为44例。参照组给予常规治疗,实验组在参照组的基础上给予Bi PAP呼吸机治疗,比较两组患者的临床疗效与评估。结果治疗后,实验组患者的第一秒用力呼气容积(FEV1)为(1.88±0.75)L、FEV1/用力肺活量(FVC)为(65.50±4.43)%以及呼气流速峰值(PEF)为(7.89±0.35)L/s,显著高于参照组的(1.58±0.77)L、(59.60±4.19)%以及(6.59±0.42)L/s,差异有统计学意义(P<0.05);两组患者治疗后Pa O2、Sa O2、PH值均高于治疗前,Pa CO2与治疗前比较明显降低,差异均有统计学意义(P<0.05),且实验组治疗后的数据明显高于参照组,两组间比较差异有统计学意义(P<0.05)。结论采用Bi PAP通气治疗重度支气管哮喘急性发作期患者,具有显著的临床疗效,能改善患者的肺功能以及血气指标,在临床治疗中值得推广应用。

Objective To investigate the clinical practice and evaluation of bi-level positive airway pressure(BiPAP)with oral nose mask in the treatment of severe bronchial asthma during acute attack.Methods Eighty-eight cases of severe bronchial asthma during acute attack in our hospital from October 2017 to December 2017 were selected and divided into experimental group and reference group by random number table,with 44 cases in each group.The reference group was given conventional treatment,while the experimental group was given BiPAP ventilator treatment on the basis of the reference group.The clinical efficacy and evaluation of the two groups were compared.Results After treatment,the first second forced expiratory volume(FEV1)of the experimental group was(1.88±0.75)L,FEV1/forced vital capacity was(65.50±4.43)%and peak expiratory flow velocity(PEF)was(7.89±0.35)L/s,which was significantly higher than(1.58±0.77)L,(59.60±4.19)%and(6.59±0.42)L/s of those in the reference group,and the difference was statistically significant(P<0.05);After treatment,the PaO2,SaO2 and pH values of the two groups were all higher than those before treatment.PaCO2 was significantly lower than before treatment,and the difference was statistically significant(P<0.05).The data of the experimental group after treatment were significantly higher than that of the reference group,and the difference between the two groups was statistically significant(P<0.05).Conclusion BiPAP ventilation has a significant clinical effect in the treatment of severe bronchial asthma during acute attack,and it can improve the pulmonary function and blood gas index of the patients.It is worth popularizing in clinical treatment.