CPAP和BiPAP无创通气治疗重症哮喘的疗效比较

目的 比较持续正压通气(CPAP)和双水平正压通气(BiPAP)两种无创通气模式治疗重症哮喘患者的临床效果.方法 重症哮喘患者37例,在常规药物治疗的基础上,随机分为CPAP组和BiPAP组.观察两组患者治疗后生命体征、动脉血气、气管插管率、依从率、有效率、病死率和住院天数等指标.结果 两组患者治疗后生命体征、动脉血气、气管插管率均有改善,且两组患者依从率、有效率、病死率、住院时间比较差异无统计学意义(P＞0.05),但BiPAP组患者二氧化碳分压(PaCO2)降低更快,差异有统计学意义(P＜0.05).结论 CPAP和BiPAP无创通气均可改善重症哮喘患者生命体征、动脉血气和降低气管插管率,而BiPAP通气模式在改善二氧化碳潴留方面更有优势,所以对于重症哮喘合并Ⅰ型呼吸衰竭患者两种通气方式均可选择,而重症哮喘合并Ⅱ型呼吸衰竭患者推荐使用BiPAP通气.

Efficacy of CPAP versus BiPAP in treatment of severe asthma

Objective To explore the clinical effect of CPAP versus BiPAP in the treatment of patients with severe asthma.Methods 37 patients with severe asthma were randomly divided into two groups:continuous positive airway pressure (CPAP) group and BiPAP group.After the treatment,the vital signs,arterial blood gas,endotracheal intubation rate,compliance rate,effective rate,mortality,and length of hospital stay,and other indicators were observed in both groups.Results After the treatment,the vital signs,arterial blood gas,and trachea intubation rate were improved in both groups and there were no statistical differences in the compliance rate,efficacy,mortality,length of hospital stay between these two groups (P＞0.05),but carbon dioxide partial pressure (PaCO2) decreased faster in the BiPAP group,with a statistical difference (P＜0.05).Conclusions Both CPAP and BiPAP noninvasive ventilation can improve the vital signs and arterial blood gas and reduce the rate of tracheal intubation in patients with severe asthma.And BiPAP ventilation in improving dioxide retention has more advantages,so for patients with severe asthma combined with type Ⅰ respiratory failure both ventilation modes can be selected,and for patients with severe asthma combined with type Ⅱ respiratory failure BiPAP ventilation is recommended.