摘要
目的探讨无创正压机械通气治疗重症急性哮喘合并呼吸衰竭的临床效果。方法对石河子大学医学院第一附属医院2014-04至2017-04收治的58例重症急性哮喘合并呼吸衰竭患者的临床资料进行回顾性分析。按治疗方法的不同将其分成观察组(n=29)和对照组(n=29),对照组给予氧支持、解痉、平喘、祛痰、激素抗炎等常规急救干预,观察组在对照组的基础上给予无创正压通气治疗。比较两组生命体征、血气分析、血清炎性因子等指标的变化。结果 (1)同组内比较,与治疗前相比,观察组及对照组治疗后1 d、3 d的心率、呼吸频率(respiratory rate,RR)、动脉二氧化碳分压(partial pressure of carbon dioxide in artery,Pa CO_2)、白细胞介素-17(interleukin-17,IL-17)均显著降低(P<0.0167),血氧分压(partial pressure of oxygen,Pa O_2)均显著增高(P<0.0167);与治疗后1 d比较,观察组及对照组治疗后3 d的心率、RR、Pa CO_2、IL-8、IL-17均显著降低,Pa O_2显著升高(P<0.0167)。(2)组间比较,观察组治疗后1 d的RR、心率、Pa CO_2较对照组同时间点降低更显著,Pa O_2升高更明显(P<0.0167);观察组治疗后3 d的Pa CO_2、IL-8、IL-17较对照组同时间点降低更显著,Pa O_2升高更明显(P<0.0167)。(3)治疗后观察组总有效率为89.66%优于对照组的68.96%,差异具有统计学意义(χ~2=5.497,P=0.019)。结论对重症急性哮喘合并呼吸衰竭患者实施无创正压通气治疗可明显改善其血气和相关炎性因子指标,提高治疗有效率,降低转有创机械通气治疗的概率,具有临床推广意义。
Objective The objective of this study wzs to investigate the clinical effect of noninvasive positive pressure ventilation in the treatment of severe acute asthma complicated with respiratory failure. Methods A sample of 58 patients with severe acute respiratory distress complicated with respiratory failure treated in hospital from April 2014 to April 2017 was analyzed retrospectively. The sample was divided into the observation group （n=29） and control group （n=29） based on the different treatment methods. The control group was given oxygen support, asthma, expectorant, antispasmodic, anti-inflammatory and other hormone routine emergency intervention, while the observation group was provided with noninvasive positive pressure ventilation treatment on the basis of the control group. The parameters of vital signs, blood gas analysis and serum inflammatory faetors were compared between the two groups. Results （1） The heart rate, RR, PaCO2, IL-17 of observation group and control group at 1 d and 3 d after treatment was significantly decreased as compared to the control group （/～〈0.0167）, while Pa02 was significantly higher （P〈0.0167）; compared with 1 d after treatment, heart rate, RR, PaC02, IL-17, IL-8 of observation group and control group 3 d after treatment significantly decreased （P〈0.0167）, while Pat2 was significantly higher （P〈0.0167）. （2） Compared between two groups, the difference of each index between two groups had no statistical significance; the heart rate, RR, PaC02 of observation group 1 d after treatment decreased more significantly compared with the same time point of control group, while Pa02 significantly increased （P〈0.0167）; the PaCO：, IL-8, IL-17 of observation group 3 d after treatment decreased more significantly compared with the same time point of control group, while Pat2 significantly increased （P〈0.0167）. （3） After treatment, the total effective rate of observation group was 89.66% （26/29）, which was significantly higher tha
出处
《中华灾害救援医学》
2017年第8期450-453,共4页
Chinese Journal of Disaster Medicine
关键词
无创正压通气
重症急性哮喘
呼吸衰竭
noninvasive positive pressure ventilation
severe acute asthma
respiratory failure
