双水平气道正压通气治疗中晚期妊娠重度哮喘的临床研究

目的研究无创通气在中晚期妊娠重度哮喘治疗中对胎儿、动脉血气指标（pH、PaO2、PaCO2、SaO2）、心率（HR）和呼吸频率（RR）的影响。方法将30例中晚期妊娠重度支气管哮喘患者随机分为无创通气（双水平鼻/面罩NIPPV）＋药物治疗组（实验组15例）和对照组（15例）。比较治疗后两组动脉血气指标（pH、PaO2、PaCO2、SaO2）变化以及对胎儿发育的影响,观察患者临床症状、HR和RR。结果实验组血气指标的改善以及监测HR、RR下降均优于对照组（P〈0.01）。结论在常规药物治疗的基础上,采用双水平鼻/面罩NIPPV用于妊娠期重度哮喘的治疗,安全有效,可减少气管插管率,减少对胎儿的不良影响。

Clinical research of bi-level positive airway pressure ventilation in treatment of severe asthma in midlate pregnancy

Objective To study the clinical value of bi-level positive airway pressure(BiPAP)ventilation in treatment of severe asthma in mid-late pregnancy:influence of the foetus,changes of pH,PaO2,PaCO2,SaO2 in the arterial blood gas,heart rate(HR)and respiratory rate(RR).Methods Thirty cases of severe asthma in mid-late pregnancy were randomly divided into two groups.One group were treated by drugs(control group),the other group were treated by noninvasive positive pressure ventilation(NIPPV)and the drugs(experiment group)with 15 cases in each group.The experiment group was treated with BiPAP ventilation via facial(nasal)mask.The comparison was made on the changes of the arterial blood gas before and after the treatment between two groups.And also influence of the foetus, the changes of clinical symptom,HR and RR were obtained before treatment.Results Significant differences were found in the experiment group of the improvement of PaO2,PaCO2,SaO2,HR,RR,compared with those of the control group(P<0.01).Conclusion On the foundation of conventional medicine cure,double-level nasal mask/mask ventilation mode is used for the treatment of severe asthma in mid-late pregnancy,and it can effectively reduce tracheal intubation rate and influence of the foetus.