双水平无创通气在中重度支气管哮喘急性发作期的应用

目的对比常规治疗与常规治疗联合双水平无创通气治疗中重度支气管哮喘急性发作的临床效果。方法选择中重度支气管哮喘急性发作期的患者32例作为研究对象，随机分为治疗组和对照组，对照组仅采用常规静脉激素应用及雾化吸入平喘药，根据情况加用抗生素，治疗组在对照组治疗的基础上联用双水平无创通气，两组均在治疗前、治疗后30min、60min、2h、24h、48h及72h及停用无创通气1d后分别记录指脉氧饱和度、心率、呼吸频率、动脉血气分析、询问患者呼吸困难缓解情况、两肺哮鸣音减少及消失情况，无创通气仅用3d，在治疗前、治疗3d及4d后行肺功能检查，记录FEV，占预计值百分比及FVC。结果两组患者的FEV．占预计值百分比、呼吸频率、PaC2，等指标均有改善，但治疗组在同一时间点的各项指标均明显优于对照组，且治疗组的症状、体征缓解得更快，而两组治疗后PaCO2、FVC及心率虽较治疗前均有好转，但两组间差异无统计学意义。结论对于中重度支气管哮喘急性发作期的患者，可以在常规治疗的基础上联用双水平无创通气。

Application of BiPAP in treatment of moderate and severe asthma in acute stage

Objective To compare the different effects of conventional therapy and BiPAP plus conventional therapy on patients with acute moderate or serious bronchial asthma. Methods Thirty-two cases of moderate or serious bronchial asthma in acute stage were chose. Sixteen patients were given Bi- PAP plus conventional therapy and 16 patients were given conventional therapy alone. Both groups had similar clinical characteristics on hospital admission. Bedside lung function test results and vital signs, such as SaO2, HR, RR, PaO2, PaCO2,were obtained at baseline, and during at 30 min, 1 h, 2 h, 24 h, 48 h, 72 h and at the end and one day after the study protocol. At the third and fourth day, lung function and record FEV1 , FVC were examined. Results After 3 days ventilation, the levels of FEV1, PaCO2 and breath rate of the two groups all improved, but the BiPAP group was superior to control group in each indexes at the given time, and the time of dyspnea alleviation and dispearance were shorter signif-icantly in BiPAP group. So most patients avoided invasive ventilation. Conclusions It is effective to treat the patients of bronchial asthma by BiPAP plus conventional therapy.