氯胺酮辅助无创正压通气治疗哮喘急性重症发作的疗效观察

目的观察氯胺酮辅助无创正压通气对重症哮喘急性发作的治疗作用。方法选择2004年1月—2007年10月入住我院的重症哮喘急性发作患者106例,随机分为两组,标准治疗组(A组)和标准治疗组 无创正压通气与氯胺酮治疗组(B组)。比较两组的治疗效果。结果治疗后24hB组患者二氧化碳分压(PaCO2)、氧分压(PaO2)、pH值、痰液中硝酸盐/亚硝酸盐(NO3/NO2)、呼吸频率(R)与A组的比较差异有统计学意义(P<0.05)。B组患者有效率与A组比较差异有统计意义(P<0.05)。结论应用无创正压通气与氯胺酮治疗重症哮喘患者,不但能改善患者的通气功能,降低气道阻力,减少气管插管的需求,而且能减轻患者与呼吸机相拮抗,提高治疗效果,降低病死率。

Effect of Ketamine with Noninvasive Positive Pressure Ventilation on Acute Severe Asthmatics

Objective To evaluate the effect of Ketamine with assistant of noninvasive positive pressure ventilation(NPPV)to patients with acute episode of severe asthma.Methods Totally 106 inpatient with acute episode of severe asthma from January 2004 to October 2007 were randomly divided as group A(standard treatment)and group B(standard treatment plus Ketamine with assistant of NPPV).The therapeutic effects of the two groups were compared.Results After 24 hours treatment the PaCO2,PaO2,PH value,the ratio of nitrate/nitrite and respiratory rate of the patients in group B showed significant differences from those in group A(P<0.05).The therapeutic effect of group B was better than that of group A(P<0.05).Conclusion NPPV combined with Ketamine can not only improve the ventilation function of the patients to lower the airway resistance and reduce the demand for tracheal intubation,but also lighten antagonism of the patient to breathing machine so as to increase the effect and reduce the mortality rate.