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1990～1996年,我们收治危重型支气管哮喘患者17例,全部抢救成功。 临床资料:本组男9例,女8例;年龄38～92岁;病史8～62年。入院前哮喘发作持续3～6天。入院时端坐呼吸、多汗、重度紫绀;心率平均118次/min,呼吸平均29次/min,血压低于12/8kPa2例;精神错乱2例,浅昏迷1例。合并呼吸性酸中毒8例,代酸4例。心电图示电轴右偏9例,肺型P波11例。合并冠心病2例,糖尿病1例。 治疗方法:①一般治疗:绝对卧床,吸氧,在痰培养的基础上合理使用抗生素,在监测血生化及动脉血气的基础上纠正水电解质紊乱,注意足量补钾,需要吸痰者先给予气管内滴注药物再吸痰。②应用平喘药物:静脉用氨茶碱(0.8～1.05g/d)及氟美松(10～20mg/d),口服β_2受体兴奋剂(舒喘灵或博利康尼),无昏迷者使用抗组织胺药(酮替芬)。治疗1～2天效果不明显者,可增加氟美松用量(20～
From 1990 to 1996, we treated 17 patients with critically ill patients with bronchial asthma, all of whom were successfully rescued. Clinical data: The group of 9 males and 8 females; aged 38 to 92 years; history of 8 to 62 years. Asthma attack before admission for 3 to 6 days. Admission when sitting breathing, sweating, severe cyanosis; heart rate average 118 times / min, breathing average 29 times / min, blood pressure lower than 12 / 8kPa 2 cases; delirium in 2 cases, 1 case of shallow coma. Respiratory acidosis in 8 cases, 4 cases of acid. Electrocardiogram axis 9 cases of right deviation, pulmonary P wave in 11 cases. Coronary heart disease in 2 cases, 1 case of diabetes. Treatment: ① general treatment: absolute bed, oxygen, the rational use of sputum culture on the basis of antibiotics, monitoring blood biochemical and arterial blood gas on the basis of correcting water and electrolyte disorders, pay attention to enough potassium, need to be given sputum aspiration Intratracheal instillation of drugs and then sputum. ② The use of antiasthmatic drugs: intravenous aminophylline (0.8 ~ 1.05g / d) and dexamethasone (10 ~ 20mg / d), oral β_2 receptor stimulants (salbutamol or bortrolidin), no coma Use antihistamines (ketotifen). Treatment of 1 to 2 days was not obvious effect, can increase the amount of dexamethasone (20 ~