无创机械通气在急性重症支气管哮喘院前急救中的应用

目的探讨鼻（面）罩式无创机械通气在急性重症支气管哮喘院前急救中的临床疗效。方法将63例院前急性重症支气管哮喘患者随机分为A、B两组。A组31例常规给予解痉、平喘、抗炎、氧疗、激素等常规治疗；B组32例常规治疗基础上加用BiPAP（双水平呼吸道正压通气）呼吸机行鼻（面）罩式无创机械通气治疗，观察疗效。结果A、B两组患者的呼吸频率、心率、血氧浓度均较前有明显改善（P〈0．01）。与A组比较，B组在治疗后患者的呼吸频率、心率、血氧浓度改善优于A组（P〈0．05），治疗后症状缓解的时间明显短于A组（P〈0．01）。结论危急重症支气管哮喘患者院前急救治疗中早期采用无创机械通气等综合治疗措施可有效改善患者的疗效，效果优于常规治疗。

Prehospital Emergency Application of Noninvasive Mechanical Ventilation on Acute and Severe Bronchial Asthma

Objective To study the clinical efficacy of the prehospital emergency application of nasal （facial） mask noninvasive mechanical ventilation on acute and severe bronchial asthma. Methods 63 cases of pre-hospital patients with acute severe bronchial asthma were randomly divided into group A and group B. The 31 cases of group A was only given conventional therapy to ease spasm and asthma and used anti-inflammatory, oxygen therapy, hormones and other conventional therapy. Based on the conventional therapy, the 32 cases of group B was given bi-level positive airway pressure ventilation to nasal breathing machine in order to perform （facial） Mask Nasal intermittent positive pressure mechanical ventilation and observed the effect. Results The respiratory rate, heart rate and SaO2 of group A and group B patients had significantly improved. （P 〈 0.01）. Compared with group A, the respiratory rate, heart rate and SaO2 of group B patients were better than those in group A （ P 〈 0.05 ）, the symptomatic relief time after treatment was significant - ly shorter than group A （P 〈 0.01 ）. Conclusion In pre-hospital emergency treatment, severe asthma emergency of early adopting nasal intermittent positive pressure ventilation can effectively improve the conditions of patient, and shows this method is superior to conventional therapy.