无创通气不同通气模式对重症哮喘患者的疗效对比

Comparison of the efficacy of noninvasive ventilation with different ventilation modes in patients with severe asthma

目的对比重症哮喘患者应用无创通气不同通气模式治疗的效果。方法 92例重症哮喘患者作为研究对象,均予常规药物治疗及无创通气。按通气模式的不同分为参照组(42例)及研究组(50例)。参照组进行持续正压通气(CPAP),研究组进行双水平正压通气(BiPAP)。比较两组患者通气前后动脉血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、肺功能指标[第1秒用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)]的变化情况。结果通气后,两组患者的PaO_(2)较本组通气前升高, PaCO_(2)较本组通气前降低,且研究组患者的PaO_(2)(66.24±12.86)mm Hg(1 mm Hg=0.133 kPa)高于参照组的(55.25±10.32)mm Hg, PaCO_(2)(42.37±6.28)mm Hg低于参照组的(51.24±9.21)mm Hg,差异均具有统计学意义(P<0.05)。通气后,两组患者的FEV1、FEV1/FVC较本组通气前升高,且研究组患者的FEV1(2.81±0.81)L、FEV1/FVC(72.58±7.79)%高于参照组的(2.02±0.58)L、(62.14±6.83)%,差异均具有统计学意义(P<0.05)。结论 BiPAP能够显著改善重症哮喘患者的动脉血气指标及肺功能,效果优于CPAP。

Objective To compare the effect of noninvasive ventilation with different ventilation modes in patients with severe asthma. Methods A total of 92 patients with severe asthma as study subjects, and all of which were treated with conventional medications and non-invasive ventilation. According to different ventilation modes, they were divided into reference group(42 cases) and research group(50 cases). The reference group received continuous positive airway pressure(CPAP), and the research group received bi-level positive airway pressure(BiPAP). The arterial blood gas indexes [arterial partial pressure of oxygen(PaO_(2)), arterial partial pressure of carbon dioxide(PaCO_(2))], and lung function indexes [forced expiratory volume in the first second(FEV1), FEV1/forced vital capacity(FVC)] before and after ventilation were compared between the two groups. Results After ventilation, the PaO_(2) of the two groups were higher than those before ventilation, and PaCO_(2) was lower than that before ventilation;the PaO_(2)(66.24±12.86) mm Hg(1 mm Hg=0.133 kPa) of the research group was higher than(55.25±10.32) mm Hg of the reference group, and PaCO_(2)(42.37±6.28) mm Hg was lower than(51.24±9.21) mm Hg of the reference group. All the difference was statistically significant(P<0.05). After ventilation, the FEV1 and FEV1/FVC of the two groups were higher than those before ventilation, and the FEV1(2.81±0.81) L and FEV1/FVC(72.58±7.79)% of the research group were higher than(2.02±0.58) L and(62.14±6.83)% of the reference group, and the difference was statistically significant(P<0.05). Conclusion BiPAP can significantly improve arterial blood gas index and lung function in patients with severe asthma, and the effect is better than BiPAP.