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双水平正压无创通气治疗急性中重度支气管哮喘的临床观察(1)
http://www.100md.com 2012年4月5日 张雪彦 赵晔
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     [摘要] 目的 观察双水平正压无创通气治疗急性中重度支气管哮喘的临床疗效。方法 将68例确诊为中重度哮喘急性发作的患者随机分为治疗组和对照组各34例。对照组给予常规治疗,治疗组在常规治疗基础上早期给予BiPAP治疗。比较两组患者治疗前后48 h的血气分析(pH值、PaCO2、PaO2、SaO2)、肺功能(FEV1、FEV1/FVC%、PEF)及最终观察指标(治愈率、气管插管率、死亡率、平均住院日)。 结果 治疗组动脉血气指标与肺功能改善及最终观察指标均优于对照组 (P < 0.05)。 结论 双水平正压无创通气治疗可以明显改善患者的血气指标及肺功能,缩短住院时间,降低死亡率,是治疗急性中重度支气管哮喘的有效方法。

    [关键词] 支气管哮喘;双水平气道内正压通气;血气分析;肺功能

    [中图分类号] R562.2+5 [文献标识码] A [文章编号] 1674-4721(2012)04(a)-0065-02

    Clinical observation of bi-level positive airway pressure noninvasive ventilation in acute moderate and severe bronchial asthma

    ZHANG Xueyan ZHAO Ye

    Department of Respiratory, the Seventh People's Hospital of Shenyang in Liaoning Province, Shenyang 110003, China

    [Abstract] Objective To observe the clinical efficacy of BiPAP non-invasive mechanical ventilation treatment on patients with acute moderate and severe bronchial asthma. Methods Sixty eight patients diagnosed with moderate to severe acute asthma were randomly divided into treatment group and control group of 34 cases. Control group received conventional therapy, the treatment group were given early treatment based on the Bi-PAP therapy. Patients were compared before and after 48 h of blood gas analysis (pH, PaCO2, PaO2, SaO2), pulmonary function (FEV1, FEV1/FVC%, PEF) and the final observed indicators (cure rate, endotracheal intubation rate, mortality, average length of stay). Results Treatment group, arterial blood gas indicators and indicators of pulmonary function improvement and ultimately better than the control group observed (P < 0.05). Conclusion Bi-level positive airway pressure noninvasive ventilation can significantly improve the patient's blood gas analysis and pulmonary function, shorter hospital stay, reduce mortality, it is the treatment of acute moderate and severe bronchial asthma and effective way.

    [Key words] Blood gas analysis; Bronchial asthma; Bi-level positive airway pressure; Pulmonary function;

    支气管哮喘(bronchial asthma)是由多种细胞(如嗜酸粒细胞、肥大细胞、T淋巴细胞、中性粒细胞、气道上皮细胞等)和细胞组分参与的气道慢性炎性疾病[1],是内科常见的急重症之一。常规解痉平喘治疗可使一部分哮喘急性发作患者在短时间内症状缓解 ......

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