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目的探讨无创双水平正压通气(BiPAP)联合注射用甲泼尼龙琥珀酸钠治疗重症哮喘的临床疗效。方法将57例重症哮喘患者随机分为3组:对照组(18例)予静脉滴注地塞米松10mg,每日2次;观察组(20例)予静脉滴注甲泼尼龙琥珀酸钠80mg(每8h1次);研究组(19例)予静脉滴注甲泼尼龙琥珀酸钠80mg(每8h1次)联合BiPAP通气,比较3组患者的血气指标、生理指标的变化及气管插管率、肺炎发生率。结果研究组第1 h各指标迅速改善,第24 h时各观察指标接近正常值范围,与治疗前比较差异显著(P<0.01);且明显优于观察组与对照组。研究组气管插管率、肺炎发生率最低,与其他两组比较有统计学意义(P<0.05)。结论 BiPAP通气联合注射用甲泼尼龙琥珀酸钠是救治重症哮喘有效方法,值得临床推广应用。
Objective To investigate the clinical efficacy of noninvasive bi-level positive pressure ventilation (BiPAP) in combination with methylprednisolone sodium succinate in the treatment of severe asthma. Methods Fifty-seven patients with severe asthma were randomly divided into three groups: control group (n = 18) received intravenous dexamethasone 10 mg twice daily; observation group (n = 20) received intravenous methylprednisolone succinate 80 mg (Once every 8h). The study group (19 cases) received intravenous methylprednisolone sodium succinate 80mg (every 8h1 times) combined with BiPAP ventilation. The changes of blood gas indexes, physiological indexes and tracheal intubation rate were compared among the three groups. The incidence of pneumonia. Results The indexes of 1 h in the study group improved rapidly. Each observation index was close to the normal range at 24 h, which was significantly different from that before treatment (P <0.01), and obviously better than the observation group and the control group. The study group tracheal intubation rate, the lowest incidence of pneumonia, compared with the other two groups was statistically significant (P <0.05). Conclusion BiPAP ventilation with methylprednisolone sodium succinate injection is an effective treatment of severe asthma, which is worthy of clinical application.