双相正压通气在开胸手术后急性发作重症哮喘患者中的疗效

目的探讨双相正压通气在开胸手术后突发哮喘危重状态时的疗效.方法8例术前无哮喘病史的重症哮喘患者,积极内科治疗无效后,经气管插管行双相正压通气,观察并分析治疗前2 h,治疗后4 h的血气结果和气道压变化.结果患者实施双相正压通气后4 h,PaO2(P＜0.01)、PaCO2(P＜0.05)、pH(P＜0.05)以及SaO2%(P＜0.05)和PaO2/FiO2(P＜0.05)较治疗前明显改善;患者气道压降低(P＜0.01),气道痉挛明显缓解.结论双相正压通气用于重症哮喘并呼吸衰竭的治疗是安全有效和可行的.

Management of severe postthoracotomy asthmatic attack by bi-phasic positive airway pressure ventilation

Objective To evaluate the clinical value of bi-phasic positive airway pressure (Bi-PAP) in severe asthmatic attack patients after thoracic operation. Methods Eight severe asthma patients without asthma history who failed to medical treatment were treated with Bi-PAP. Arterial blood gas and airway pressure 2 h before treatment and 4 h after treatment were observed and analyzed by Bi-PAP ventilation of tracheal intubation. Results There were significant improvement of PaO_ 2 (P<0.01), PaCO_ 2(P<0.05), pH(P<0.05), SaO_ 2% (P<0.05) and PaO_ 2/FiO_ 2 (P<0.05) in 4 h after Bi-PAP ventilation, as compared with those before Bi-PAP ventilation (P<0.01), which proved to be able to degrade airway and relieve airway spasm. The artery blood gases and vital sign continued to improve 4 h after Bi-PAP ventilation. Conclusion Bi-PAP ventilation is effective and safe for the patients with severe asthmatic attack and for those whose conditions cannot be improved with medical management.