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目的:探讨无创正压通气(NPPV)在高海拔地区治疗重症支气管哮喘的有效及安全性。方法:68例重症支气管哮喘患者随机分为治疗组(NPPV组)37例,对照组(non-NPPV组)31例;治疗组在常规治疗基础上加NPPV,对照组常规治疗。结果:治疗2 d后两组患者的呼吸频率(RR)、心率(HR)、动脉血pH、PaO2、PaC02、SaO2均有明显改善(P<0.01);治疗组在治疗24 h和3 d后pH、PaO2、PaC02、SaO2改善优于对照组(P<0.01),住院天数、插管率及死亡率明显低于对照组(P<0.01)。结论:高海拔地区重症支气管哮喘在常规治疗基础上加NPPV治疗可有效改善症状,纠正缺氧,减少气管插管率,降低病死率,缩短住院时间及降低住院费用。
Objective: To investigate the efficacy and safety of noninvasive positive pressure ventilation (NPPV) in the treatment of severe bronchial asthma in high altitude areas. Methods: Sixty-eight patients with severe bronchial asthma were randomly divided into treatment group (NPPV group) 37 cases and control group (non-NPPV group) 31 cases. The treatment group was treated with NPPV on the basis of routine treatment and the control group received routine treatment. Results: The respiratory rate (RR), heart rate (HR), arterial blood pH, PaO2, PaCO2 and SaO2 in both groups after 2 days of treatment were significantly improved (P <0.01). After treatment for 24 and 3 days The improvement of pH, PaO2, PaCO2 and SaO2 was better than that of the control group (P <0.01). The days of hospitalization, intubation and mortality were significantly lower than those of the control group (P <0.01). Conclusion: The treatment of severe bronchial asthma in high altitude area on the basis of conventional treatment plus NPPV can effectively improve the symptoms, correct hypoxia, reduce tracheal intubation rate, reduce mortality, shorten hospital stay and reduce hospitalization costs.