急诊无创正压通气联合小剂量肾上腺素治疗重症支气管哮喘合并呼吸衰竭的临床效果研究

摘要

Objective:To study the clinical efficacy of non invasive positive pressure ventilation combined with small dose of Epinephrine in the treatment of severe bronchial asthma complicated with respiratory failure. Method:From June 2012 to May 2016 70 cases of severe bronchial asthma with respiratory failure patients, two groups were given basic treatment,oxygen,asthma,anti-inflammatory hormone,treatment and routine emergency antispasmodic expectorant,the control group received noninvasive positive pressure ventilation treatment,on the basis of above the observation group treated with small doses of Epinephrine.Result:The changes of RR and HR in two groups after 72 h treatment were significant (P<0.05),there were statistically significant differences between two groups of RR and HR after 72 h treatment(P<0.05).The content of PaO2 and pH value in two groups were significantly increased after 72 h treatment,the content of IL-17,ECP,MPO,MDC in two groups reduced significantly after 72 h treatment(P<0.05).The content of PaO2 of the observation group was significantly higher than that of the control group after 72 h treatment(P<0.05),The content of PaCO2 of the observation group was significantly lower than that of the control group after 72 h treatment(P<0.05).There were statistically significant differences between two groups of efficiency of treatment and invasive positive pressure ventilation after 72 h treatment(P<0.05).Conclusion:Non invasive positive pressure ventilation combined with small dose of Epinephrine in the treatment of severe bronchial asthma with respiratory failure can significantly improve the blood gas and inflammatory factors,and effectively improve the clinical efficacy.%目的：研究急诊无创正压通气方法联合小剂量肾上腺素对重症支气管哮喘合并呼吸衰竭的临床实际疗效。方法：选择2012年6月-2016年5月本院收治的70例重症支气管哮喘合并呼吸衰竭患者，两组均给予基础治疗，吸氧、平喘、激素抗炎、解痉以及祛痰等常规急救处理，对照组实施无创正压通气治疗，观察组在此基础上加用小剂量肾上腺素治疗。结果：两组RR与HR治疗72 h变化均显著（P<0.05），两组RR与HR治疗72 h比较差异均有统计学意义（P<0.05）。两组治疗72 h后PaO2含量显著上升，PaCO2含量显著下降，pH值显著上升，IL-17含量显著降低，ECP含量显著降低，MPO含量显著降低，MDC含量显著降低（P<0.05）。治疗72 h后观察组PaO2含量显著高于对照组，PaCO2含量显著低于对照组（P<0.05）。两组治疗有效率、转有创通气率比较，差异均有统计学意义（P<0.05）。结论：急诊无创正压通气联合小剂量肾上腺素治疗可以显著改善重症支气管哮喘合并呼吸衰竭的血气以及炎症因子指标，有效提高临床疗效。