无创正压通气联合小剂量肾上腺素在重症哮喘伴呼吸衰竭治疗中的应用效果

Application effect of noninvasive positive pressure ventilation combined with low-dose adrenaline in the treatment of severe asthma with respiratory failure

目的探讨无创正压通气联合小剂量肾上腺素在重症哮喘伴呼吸衰竭治疗中的应用效果。方法选取2020年3月至2021年4月福建医科大学附属第一医院收治的1000例重症哮喘伴呼吸衰竭患者作为研究对象,采用随机数字表法分为观察组(500例)与对照组(500例)。观察组采用无创正压通气联合小剂量肾上腺素治疗,对照组采用小剂量肾上腺素治疗。比较两组患者治疗后临床疗效、治疗前后动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、pH值,以及治疗过程中并发症总发生率。结果观察组总有效率高于对照组,差异有统计学意义(P<0.05);治疗3 d后两组患者PaO_(2)、pH值高于治疗前,且观察组治疗3 d后PaO_(2)、pH值高于对照组,差异有统计学意义(P<0.05);治疗3 d后两组患者PaCO_(2)低于治疗前,且观察组治疗3 d后PaCO_(2)低于对照组,差异有统计学意义(P<0.05);观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论无创正压通气联合小剂量肾上腺素治疗重症哮喘伴呼吸衰竭,能够改善患者血气指标,降低患者并发症总发生率,提高治疗效果。

Objective To investigate the effect of noninvasive positive pressure ventilation combined with low-dose adrenaline in the treatment of severe asthma with respiratory failure.Methods A total of 1000 patients with severe asthma with respiratory failure treated in the First Affiliated Hospital of Fujian Medical University from March 2020 to April 2021 were randomly divided into observation group(500 cases)and control group(500 cases)by random number table method.The observation group was treated with noninvasive positive pressure ventilation combined with low-dose adrenaline,and the control group was treated with low-dose adrenaline.The clinical efficacy,arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),pH and the incidence of complications(pneumothorax,bronchitis and atelectasis)were compared between the two groups before and after treatment.Results The total effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).After 3 days of treatment,the PaO_(2)and pH values of the two groups were higher than those before treatment,and the PaO_(2)and pH values of the observation group were higher than those of the control group after 3 days of treatment,and the differences were statistically significant(P<0.05).After 3 days of treatment,the PaCO_(2)in the two groups was lower than that before treatment,and the PaCO_(2)in the observation group was lower than that in the control group after 3 days of treatment,and the difference was statistically significant(P<0.05).The total incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Noninvasive positive pressure ventilation combined with low-dose adrenaline in the treatment of severe asthma with respiratory failure can improve the blood gas index,reduce the incidence of complications and improve the therapeutic effect.