无创呼吸机在支气管哮喘合并肺炎治疗中的应用价值

Clinical value of non-invasive ventilator in the treatment of bronchial asthma with pneumonia

目的探讨无创呼吸机在支气管哮喘合并肺炎患者治疗中的应用价值.方法选择义乌市第二人民医院2016年6月至2018年6月收治的支气管哮喘合并肺炎患者90例作为观察对象,采用随机数字表法分为观察组和对照组各45例,对照组组给予常规治疗与护理,观察组在对照组的基础上给予无创呼吸机辅助治疗,两组患者均治疗7 d.比较两组治疗前后的血气指标[pH值、氧分压(PaO2)、二氧化碳分压(PaCO2)、动脉血氧饱和度(SaO2)]、肺功能指标[哮喘控制测试(ACT)评分、FEV1占用力肺活量百分比(FEV1/FVC)、呼气峰值流速(PEF)、肺容量(VC)]、气道功能指标[达峰容积比(PFV)、呼出75%潮气量时的呼气流速/潮气呼气峰流速(25/PF)、潮气量(VT)、潮气呼气中期流速/潮气吸气中期流速(ME/MI)]、治疗过程中的并发症及住院时间.结果治疗后,观察组的PaO2(9.12±0.76)kPa、SaO2(93.72±7.59)%、ACT评分(23.67±2.13)、FEV1/FVC(73.47±5.29)%、PEF(3.68±0.58)L/s、PFV(50.36±5.27)%、25/PF(81.36±5.34)%、VT(9.31±1.56)mL/kg、ME/MI(89.12±4.63)%,均高于对照组的PaO2(7.31±0.43)kPa、SaO2(86.51±5.51)%、ACT评分(17.45±1.89)、FEV1/FVC(65.24±5.62)%、PEF(2.98±0.42)L/s、PFV(41.31±4.52)%、25/PF(72.39±5.16)%、VT(7.69±1.65)mL/kg、ME/MI(77.96±3.71)%,差异均有统计学意义(t=13.905、5.157、14.653、7.153、6.557、8.744、8.103、4.786、10.357,均P<0.05);观察组的并发症发生率(28.89%)及住院时间[(11.36±2.31)d]低于、短于对照组的55.56%、(15.46±2.68)d,差异有统计学意义(t=6.559、7.773,均P<0.05).结论无创呼吸机在支气管哮喘合并肺炎的治疗中可有效改善患者的血气指标,提高患者肺功能和气道功能,降低并发症发生率,减少住院时间,促进患者早日康复.

Objective To explore the clinical value of non-invasive ventilator in the treatment of bronchial asthma with pneumonia.Methods From June 2016 to June 2018,a total of 90 patients with bronchial asthma compli-cated with pneumonia admitted to the Second People's Hospital of Yiwu were enrolled in this study.The patients were randomly divided into observation group and control group according to the digital table,with 45 cases in each group.The control group received routine treatment and nursing.The observation group was given non-invasive ventilator-assisted treatment based on the control group,and both two groups were treated for 7 days.Blood gas indicators[pH value,partial pressure of oxygen(PaO2),partial pressure of carbon dioxide(PaCO2),arterial oxygen saturation(SaO2)],pulmonary function indicators[ACT score,FEV1 occupational vital capacity percentage(FEV1/FVC),exhalation peak flow rate(PEF),lung volume(VC)],airway function indicators[peak volume ratio(PFV),expiratory flow rate/tidal expiratory peak flow rate(25/PF)when exhaled 75%tidal volume,tidal volume(VT),tidal exhalation medium flow rate/tidal inhalation medium flow rate(ME/MI)],complications during treatment and length of hospital stay were compared before and after treatment.Results After treatment,PaO2[(9.12±0.76)kPa],SaO2[(93.72±7.59)%],ACT score[(23.67±2.13)points],FEV1/FVC[(73.47±5.29)%],PEF[(3.68±0.58)L/s],PFV(50.36±5.27)%,25/PF(81.36±5.34)%,VT(9.31±1.56)mL/mg,ME/MI(89.12±4.63)%in the observation group were higher than those in the control group[PaO2(7.31±0.43)kPa,SaO2(86.51±5.51)%,ACT score(17.45±1.89)points,FEV1/FVC(65.24±5.62)%,PEF(2.98±0.42)L/s,PFV(41.31±4.52)%,25/PF(72.39±5.16)%,VT(7.69±1.65)mL/mg,ME/MI(77.96±3.71)%],the differences were statistically significant(t=13.905,5.157,14.653,7.153,6.557,8.744,8.103,4.786,10.357,all P<0.05).The incidence of complications(28.89%)and hospitalization time[(11.36±2.31)d]in the observa-tion group were lower than those in the control group[55.56%,(15.46±2.68)d],the differences were statistically significant(t=6.559,7.773,allP<0.05).Conclusion Non-invasive ventilator can effectively improve the blood gas index of patients with bronchial asthma complicated with pneumonia,improve lung function and airway function,reduce the incidence of complications,reduce hospitalization time,and promote the early recovery of patients.It is worthy of promoting.