甲泼尼龙及异丙托溴铵联合机械通气治疗重症哮喘合并呼吸衰竭的效果分析

Effect of methylprednisolone and ipratropium bromide combined with mechanical ventilation in the treatment of severe asthma complicated by respiratory failure

目的:分析甲泼尼龙、异丙托溴铵联合机械通气治疗重症哮喘合并呼吸衰竭的效果。方法:抽取2020年7月至2022年11月河南省职工医院收治的重症哮喘合并呼吸衰竭患者86例,按随机数字表法分为观察组与对照组,每组43例。两组均行机械通气治疗,在此基础上对照组采用肾上腺素治疗,观察组采用甲泼尼龙及异丙托溴铵治疗。比较两组治疗效果、肺功能[呼吸流量峰值(PEF)、用力肺活量(FVC)]、氧合指标[血氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、血氧饱和度(SaO_(2))]、生命体征[心率、呼吸频率、平均动脉压(MAP)]、炎症指标[C反应蛋白(CRP)、降钙素原(PCT)]及不良反应发生率。结果:观察组总有效率(95.35%,41/43)高于对照组(81.40%,35/43),P<0.05。治疗后,观察组PEF、FVC高于对照组(P<0.05)。治疗后,观察组PaCO_(2)低于对照组,PaO_(2)、SaO_(2)高于对照组(P<0.05)。治疗后,观察组呼吸频率、心率、MAP均低于对照组(P均<0.05)。治疗后,观察组CRP、PCT低于对照组(P<0.05)。观察组不良反应发生率(2.33%,1/43)低于对照组(18.60%,8/43),P<0.05。结论:甲泼尼龙、异丙托溴铵联合机械通气治疗重症哮喘合并呼吸衰竭效果确切,可减轻炎性反应,有效改善肺功能、氧合功能和生命体征,并能降低不良反应发生率。

Objective To analyze the effect of methylprednisolone and ipratropium bromide combined with mechanical ventilation in the treatment of severe asthma complicated by respiratory failure.Methods A total of 86 patients with severe asthma complicated by respiratory failure in the Henan General Hospital from July 2020 to November 2022 were selected,and they were divided into observation group and control group according to random number table method,with 43 cases in each group.The two groups were treated by mechanical ventilation;in addition,the control group was treated with epinephrine,and the observation group was treated with methylprednisolone and ipratropium bromide.The curative effect,lung function assessed by peak respiratory flow(PEF)and forced vital capacity(FVC),oxygenation indexes including partial pressure of oxygen(PaO_(2)),partial pressure of oxygen in arterial blood(PaCO_(2))and blood oxygen saturation(SaO_(2)),vital signs,incluidng heart rate,respiratory rate and mean arterial pressure(MAP),inflammation indexes,including C-reactive protein(CRP)and procalcitonin(PCT),and incidence of adverse reaction of the two groups were compared.Results The total effective rate of the observation group was 95.35%(41/43),higher than the 81.40%(35/43)of the control group(P<0.05).After treatment,PEF and FVC in observation group were higher than those in control group(P<0.05).After treatment,PaCO_(2) in the observation group was lower than that in the control group,while PaO_(2) and SaO_(2) were higher than those in the control group(P<0.05).After treatment,the respiratory rate,heart rate and MAP in the observation group were lower than those in the control group all(P<0.05).After treatment,CRP and PCT in observation group were lower than those in control group(P<0.05).The incidence of adverse reactions in observation group was 2.33%(1/43),lower than the 18.60%(8/43)in control group,(P<0.05).Conclusions Methylprednisolone and ipratropium bromide combined with mechanical ventilation are effective in the treatment of severe asthma with respiratory failure,which can reduce inflammatory response,effectively improve lung function,oxygenation function and vital signs,and reduce the incidence of adverse reactions.