无创正压通气联合甲泼尼龙 异丙托溴铵治疗重症哮喘伴呼吸衰竭疗效观察

Observation on the curative effect of non-invasive positive pressure ventilation combined with methylprednisolone and ipratropium bromide in the treatment of severe asthma with respiratory failure

目的探讨无创正压通气联合甲泼尼龙、异丙托溴铵治疗重症哮喘伴呼吸衰竭的临床疗效及对患者肺功能及血气指标的影响。方法将150例重症哮喘伴呼吸衰竭患者按随机数字表法分为两组,每组75例。两组予以常规治疗及无创正压通气治疗,观察组在此基础上联合甲泼尼龙及异丙托溴铵治疗,观察7 d。比较两组临床疗效、不良反应发生状况,治疗前后肺功能(用力肺活量、呼气流量峰值)、血气指标(动脉血二氧化碳分压、动脉血氧分压)。结果观察组治疗总有效率显著高于对照组(P<0.05)。治疗后观察组用力肺活量、呼气流量峰值及动脉血氧分压均显著高于对照组(P<0.05),动脉血二氧化碳分压显著低于对照组(P<0.05)。治疗期间两组均未出现明显不良反应。结论无创正压通气联合甲泼尼龙、异丙托溴铵治疗重症哮喘伴呼吸衰竭疗效较好,能明显改善患者肺功能及血气指标,安全性高。

Objective To explore the clinical efficacy of non-invasive positive pressure ventilation combined with methylprednisolone and ipratropium bromide in the treatment of severe asthma(SA)with respiratory failure(RF)and its influence on patients'lung function and blood gas indexes.Methods A total of 150 SA patients with RF were divided into two groups according to random number table method,with 75 cases in each group.Both groups were given conventional treatment and NIPPV.The observation group was treated with methylprednisolone and ipratropium bromide on this basis for 7 days.The clinical efficacy,adverse reactions,lung function[forced vital capacity(FVC),peak expiratory flow(PEF)]and blood gas indexes[partial pressure of carbon dioxide in artery(PaCO_(2)),arterial blood oxygen partial pressure(PaO_(2))]were compared between the two groups before and after treatment.Results The total effective rate of treatment in the observation group was significantly higher than that in the control group(P<0.05).After treatment,FVC,PEF and PaO_(2) in the observation group were significantly higher than those in the control group(P<0.05),and PaCO_(2) was significantly lower than that in the control group(P<0.05).There were no obvious adverse reactions in both groups during treatment.Conclusions NIPPV combined with methylprednisolone and ipratropium bromide is effective in the treatment of severe asthma with respiratory failure.It can significantly improve the lung function and blood gas indexes of patients with high safety.