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目的:研究重度哮喘急性发作(重度哮喘)患者低潮气量机械通气治疗的效果。方法:观察12例重度哮喘患者,应用低潮气量犤lowtidalvolume,VT(5.8±0.57)mL/kg犦通气,动态测气道峰压(peakinspiratorypressure,PIP)、动脉血气、心率和血压。结果:12例患者低潮气量机械通气治疗前均有呼吸衰竭伴意识障碍。动脉二氧化碳分压(arterialcarbondioxidepressure,PaCO2)为(12.9±2.7)kPa,pH为7.14±0.02,肺泡氧分压/用力吸氧量(PaO2/FiO2)为(25±6)kPa。采用低潮气量机械通气治疗(4.6±1.5)日。治疗2小时后PaO2/FiO2明显提高犤(34±14)kPa,P<0.05犦,12小时后,PaCO2和pH开始改善(均为P<0.05)。通气时间(4.6±1.5)日。结论:在给予低潮气量通气治疗下,可迅速改善动脉血氧合,逐步降低二氧化碳分压,提高pH值。采用低潮气量治疗重度哮喘安全有效。
Objective: To study the effect of low tidal volume mechanical ventilation in patients with severe acute asthma attack (severe asthma). Methods: Twelve patients with severe asthma were observed. Low tidal volume, VT (5.8 ± 0.57) mL / kg 犦 ventilation, peak inspiratory pressure (PIP), arterial blood gas, heart rate and blood pressure were measured. Results: All 12 patients had respiratory failure and unconsciousness before low tidal volume mechanical ventilation. Arterial carbon dioxide partial pressure (PaCO2) was (12.9 ± 2.7) kPa, pH was 7.14 ± 0.02, and the alveolar oxygen pressure / PaO2 / FiO2 was (25 ± 6) kPa. Low tidal volume of mechanical ventilation (4.6 ± 1.5) days. PaO2 / FiO2 increased significantly (34 ± 14) kPa after 2 hours of treatment (P <0.05), and PaCO2 and pH began to improve after 12 hours (all P <0.05). Ventilation time (4.6 ± 1.5) days. CONCLUSION: Under the condition of low tidal volume ventilation, arterial oxygenation can be rapidly improved and the partial pressure of carbon dioxide can be gradually decreased to increase the pH value. Low tidal volume for the treatment of severe asthma safe and effective.