BiPAP无创通气对重症激素抵抗型哮喘治疗的影响

目的观察经鼻(面)罩B iPAP双水平气道正压呼吸机对激素抵抗型哮喘的临床疗效.方法对19例激素抵抗型哮喘进行鼻(面)罩B iPAP呼吸机通气治疗,并以同期同样标准的患者19例仅用常规鼻导管吸氧作对照组,观察两组治疗前后动脉血气变化及住院时间.结果治疗4 d两组动脉血氧分压明显上升,呼吸困难缓解,但治疗组上升更高(P<0.01).治疗组血二氧化碳分压比治疗前明显下降,治疗前后有显著性差异(P<0.05);对照组血二氧化碳分压治疗前后亦有显著性差异(P<0.05);治疗组和对照组治疗后动脉血氧及二氧化碳分压有显著性差异(P<0.05).治疗组总有效率为97.5%,对照组为77.8%,治疗组平均住院时间较对照组缩短4.2 d.结论应用B iPAP呼吸机辅助治疗激素抵抗型哮喘效果好,该呼吸机不用气管插管或气管切开,可使动脉血氧分压升高、二氧化碳分压降低,并发症少,并能缩短患者住院时间,患者易于接受,值得临床推广.

The Effect of Noninvasive Ventilation (NIV) in Treating Severe Asthma Resisting Incretion

Objective To study the effect of BiPAP NIV in treating severe asthma that resists incretion.Method 38 asthma patients that resist incretion were selected with 19 patients given BiPAP NIV and the other 19 patients given oxyen by nasal catheter.We study the changes of blood gas analysis and days of hospitalization.Result After 4 days' treating,two group patients' PO_2 increase obviously and their dyspnea alleviate.In BiPAP NIV group,PO_2 is higher than that of the control group(P<0.01.).PCO_2 of BiPAP NIV group decrease obviously(P<0.05).The change of PCO_2 and PO_2 are obvious between the two groups after the treatment.97.5% patients in BiPAP NIV group were treated effectively while in the control there was only 77.8%.Days of BiPAP NIV group are 4.2 days shorter than that of the control group.Conclusion BiPAP NIV is effective for severe asthma resisting incretion.It does not need trachestomy or intubatton.After BiPAP NIV treating,PCO_2 decrease and PO_2 increase.In addition,it has fewer syndrome and shorter time of hospitalization.Patients are more likely to accept BiPAP NIV treatment.It is good for general use in clinical treatment.