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我科自2003年1月-2004年5月对收住的4例重症哮喘采取了药物和机械通气综合治疗,取得了较好的效果,现报道如下。1资料和方法1.1一般资料4例患者:男3例,女1例,年龄38～65岁,平均年龄53.5岁,病程3-20年,平均9.3年。4例均表现呼吸极度喘促,端坐呼吸,大汗淋漓,明显紫绀,呼吸频率30-40次/分,心率120-140次/分;不能讲话2例,仅能吐单音2例,意识模糊2例,双肺遍布哮鸣音3例,沉默肺1例。诊断均符合哮喘危重状态的诊断标准。本次哮喘发作住院后经吸氧,控制呼吸道感染,应用足量解痉平喘药及肾上腺皮质激素,纠酸补液等治疗,病情仍进行性加重。血气分析:在鼻管吸氧2-5L/min情况下,PaO228-56mmHg,PaCO281.5-113.3mmHg,pH7.095-7.27,并出现肺性脑病的先兆。
Our department from January 2003 - May 2004 admitted to the 4 cases of severe asthma medication and mechanical ventilation combined treatment, and achieved good results, are reported below. 1 Materials and Methods 1.1 General Information 4 patients: 3 males and 1 female, aged 38 to 65 years, mean age 53.5 years old, duration of 3-20 years, an average of 9.3 years. 4 cases showed extreme asthmatic breathing, sitting and breathing, sweating, obvious cyanosis, respiratory rate 30-40 beats / min, heart rate 120-140 beats / min; can not speak in 2 cases, only vomiting in 2 cases, 2 cases of confusion, wheezing of both lungs in 3 cases, 1 case of silent lung. Diagnosis is consistent with the diagnosis of asthma critically ill. After the hospitalization of the asthma attack by oxygen, control of respiratory infections, the application of adequate antispasmodic antiasthmatic drugs and adrenal cortex hormones, acid correction fluid treatment, the condition is still progressive increase. Blood gas analysis: oxygen in the nasal tube 2-5L / min circumstances, PaO228-56mmHg, PaCO281.5-113.3mmHg, pH7.095-7.27, and a precursor to pulmonary encephalopathy.