探讨机械通气治疗重症哮喘临床应用

目的总结机械通气治疗重症哮喘的临床应用。方法对22例重症哮喘患者在给予解痉平喘、抗炎症介质、氧疗、补液、纠正酸碱失衡及抗感染等对症支持治疗的基础上皆给予机械通气治疗,根据患者病情严重程度、意识水平、气道保护能力、血流动力学等差异,分别选择无创或有创通气。其中,16例患者选择美国泰科BiPAP425ST呼吸机,采取通过鼻罩或鼻面罩进行无创机械通气治疗。其余患者则选择美国泰科Puritan Bennett840呼吸机,通过经口气管插管,实施有创机械通气治疗。结果 22例重症哮喘患者在给予通气治疗4h后以及撤机后与治疗前的动脉血气结果作对比,其pH值与PaO2恢复正常,PaCO2下降明显,与治疗前均存在明显的差异,差异有统计学意义（P〈0.01）,插管时间在1个星期之内,全部患者皆成功转出重症监护病房,生存率达100%。结论对于重症哮喘患者,尽早给予机械通气治疗,可改善相关症状,取得理想的治疗效果,值得在临床医学中推广使用。

To Explore Mechanical Ventilation Therapy of Severe Asthma Clinical Application

Objective To evaluate the clinical application of mechanical ventilation in the treatment of severe asthma. Methods 22 cases of patients with severe asthma give antispasmodic antiasthmatic, anti-inflammatory media, oxygen therapy, rehydration to correct acid-base imbalance and anti-infection on the basis of symptomatic and supportive treatment were treated with mechanical ventilation in the treatment, according to the severity of the patient＇s condition, level of consciousness, airway protection capacity, and hemodynamic differences, respectively, to select non-invasive or invasive ventilation. Of these, 16 patients chose the U.S. the Tyco BiPAP425ST breathing machine, take the non-invasive mechanical ventilation in the treatment of nasal mask or nasal mask. The remaining patients select U.S. Tyco Puritan Bennett 840 ventilator, orotracheal intubation, the implementation of invasive mechanical ventilation therapy. Results 22 cases of severe asthma patients given ventilation treatment for 4h and after weaning compared with the pre-treatment of arterial blood gas results, the pH back to normal and PaO2 , PaCO2 decreased significantly, and there are significant differences before treatment, a statistically significance （P 0.01）, intubation time in a week, all patients were successfully transferred the intensive care unit, the survival rate of 100%. Conclusion For patients with severe asthma, as soon as possible to give mechanical ventilation, can improve symptoms, to obtain the desired therapeutic effect, it is worth to promote the use in clinical medicine.