机械通气与安定联用救治重症哮喘病

目的　探讨机械通气与安定合用救治重症哮喘的价值。方法　保持输液管道通畅 ,常规心电监护 ,静推安定使患者安静 ,经气管插管后接呼吸器辅助呼吸 ,病情好转后镇静剂撤除 ,自主呼吸有力 ,Pa O2 恢复正常 ,留管观察病情无变化 ,即可拔管。结果　 2 0例患者人工机械通气中出现烦燥、人机对抗 ,使用安定后 ,人机对抗消失。经人工机械通气缺氧及二氧化碳潴留明显纠正 ,最终血气分析 Pa O2 >6 0 mm Hg,Pa CO2 35～ 45 mm Hg,p H正常。插管后 48h～ 10 d,平均 5日撤机。结论　机械通气与安定联用是救治重症哮喘的有效方法。

Sever Asthma Treated by Mechanical Ventilation Combined with Tranquillizer

Objective To evaluate the clinical values of severe asthmatic patients treated by mechanical ventilation combined with tranquillizer. Methods After tranquillizer was given intraveinously, tracheal cannula was connected with ventilator.If the patients were still agitated, tranquillizer was repeated.At the beginning, FiO 2 was usually 50% to 80%.FiO 2 was reduced to 40% to 50% when PaO 2 >60 mmHg.If PaO 2 was still less than 60mmHg, PEEP was added. When patients' condition improved (PaO 2>60mmHg), SIMV+PSV was used.Results 20 patients have shown signs of agitation during the period of ventilation.The agitation disappeared after using tranquillizer.The use of mechanical ventilation normalized the values of PaO 2 and reduced PaCO 2.The average time of withdrawing ventilator was 5 days, ranging between 2 to 10 days.Conclusion Severe asthmatics can be treated satisfactorly by using mechanical ventilation combined with tranquillizer.