摘要
目的:探讨急诊无创正压通气与小剂量肾上腺素联合治疗重症支气管哮喘并呼吸衰竭的效果,以及对细胞炎症因子、血气指标的影响.方法:选择2014年1月~2018年1月我院急诊收治的重症支气管哮喘并呼吸衰竭患者84例,以随机数表法将其分为对照组与研究组,每组各42例.两组均采取常规对症急救措施,对照组应用无创正压通气治疗,研究组在对照组的基础上应用小剂量肾上腺素治疗.评价两组临床疗效、治疗前与治疗3d时炎症因子及血气指标的变化,以及治疗期间的不良反应.结果:研究组治疗的总有效率为90.48%,高于对照组71.43%.治疗后两组IL-17、IL-8、MPO与ECP指标均低于治疗前,其中研究组IL-17、IL-8、MPO与ECP指标低于对照组.治疗后两组患者PaO2、pH值高于治疗前,PaCO2低于治疗前,其中研究组PaO2高于对照组,PaCO2低于对照组,pH值对比差异无统计学意义.研究组不良反应发生率7.14%,与对照组4.76%对比差异无统计学意义.结论:急诊无创正压通气与小剂量肾上腺素联合治疗重症支气管哮喘并呼吸衰竭疗效确切,可以有效抑制细胞炎症因子,改善血气指标,适于应用.
Objective To explore the effect of combined treatment of emergency noninvasive positive pressure ventilation and small dose adrenaline on severe bronchial asthma and respiratory failure, and the effect on inflammatory factors and blood gas. Methods 84 cases of severe bronchial asthma and respiratory failure treated in our hospital in January-2018 January 2014 were selected and divided into 42 cases in the control group and the study group by the random number table method. The two groups were treated with routine symptomatic first aid, and the control group was treated with noninvasive positive pressure ventilation, and the study group was treated with low dose adrenaline on the basis of the control group. Results The total effective rate of the study group was 90.48%, which was higher than that of the control group 71.43%. After treatment, the indexes of IL-17, IL-8, MPO and ECP in the study group were lower than those in the control group and before treatment. After treatment, the study group PaO2 was higher than the control group and before the treatment, PaCO2 was lower than the control group and before the treatment, and there was no statistical difference between the two groups. There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion The combined treatment of emergency noninvasive positive pressure ventilation and small dose adrenaline is effective in the treatment of severe bronchial asthma and respiratory failure. It can effectively inhibit cell inflammatory factors and improve blood gas index, which is suitable for application.
作者
贾仲瑞
陈广生
马德渊
李艳秋
Jia Zhong-rui;Chen Guang-sheng;Ma De-yuan;Li Yan-qiu(The First People's Hospital of Xining City Emergency Department,Xining 810000,China)
出处
《湖南师范大学学报（医学版）》
2019年第5期168-171,共4页
Journal of Hunan Normal University(Medical Sciences)
关键词
急诊无创正压通气
小剂量肾上腺素
重症支气管哮喘
呼吸衰竭
细胞炎症因子
血气指标
emergency non-invasive positive pressure ventilation
small dose of epinephrine
severe bronchial asthma
respiratory failure
cellular inflammatory factors
blood gas index
