摘要
目的探讨喉罩在抢救急性危重哮喘患者中的应用价值。方法对我院2002年至2009年应用喉罩和口鼻罩无创通气治疗的32例急性危重哮喘患者进行回顾性对比分析，其中应用喉罩（观察组）17例，应用口鼻罩（对照组）15例。分析2组血氧饱和度上升时间、呼吸机脱机时间、疾病好转时间等。结果观察组中血氧饱和度上升时间、呼吸机脱机时间、疾病转归时间[分别为（389．63±32．82）s、（19．31±2．26）h、（16．22±3．85）h]与对照组[（467．36±41．15）s、（25．18±3．73）h、（23．66±2．38）h]比较差异均有统计学意义（P均〈0．01）；无创正压通气后观察组在3、12h时动脉血二氧化碳分压（PaCO2）下降、动脉血氧分压（Pa02）升高、pH值上升，与治疗前比较差异均有统计学意义（P〈0．05或P〈0．01）；而对照组治疗后3hPaCO2、pH值则与治疗前比较差异无统计学意义（P〉0．05），但PaO2差异有统计学意义（P〈0．05），在12h时PaCO2、PaO2、pH值的变化与治疗前差异均有统计学意义（P均〈0．05）。结论在急性危重哮喘患者中选喉罩通气．更能提高通气效率．加快临康表现的缓解．
Objective To investigate the clinical value of laryngeal mask airway （LMA） in patients with acute severe asthma（ASA）. Methods 32 patients with ASA treated with LMA or mouth-nose mask during 2002 - 2009 in our hospital were retrospectively analyzed. Those treated with laryngeal mask airway was taken as observation group and those with Mouth-nose mask as control group. Results The period to oxygen saturation in arterial blood, the time to remove ventilator, and the time to disease improvement in the observation group （389.63 ± 32.82）s, （19.31 ±2.26） hours, （16.22 ±3.85） hours were different from that in control group （467.36 ±41.15 ） s, （25.18 ± 3.73 ） hours, （23.66 ± 2.38 ） hours （ P 〈 0.01 ）. After non-invasive positive pressure ventilation, PaCO2 decreased, PaO2 and pH increased at 3 and 12 hours in the observation group （P 〈0.05 or 0.01 ） from that before treatment. PaCO2 and pH at 3 hours in the control group were no significant difference before and after treatment （ P 〉 0.05 ）, with an exception of PaO2 （P 〈 0.05 ）. PaCO2, PaO2 and pH were significantly different （ P 〈 0.05 ） at 12 hours after treatment from those before treatment. Conclusions LMA should be considered in the selection of non-invasive positive-pressure ventilation （NIPPV） in patients with ASA, for a better improvement of ventilation effectiveness and accelerating the mitigation of clinical manifestations.
出处
《中国综合临床》
2010年第3期236-238,共3页
Clinical Medicine of China
关键词
急性危重哮喘
喉罩
口鼻罩
无创正压通气
动脉血气
Acute severe asthma
Laryngeal mask airway
Mouth-nose mask
Non-invasive positive- pressure ventilation
Blood gas
