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目的评价无创双水平正压通气(non-invasive bi-level positive pressure ventilation,NIPPV)治疗重症支气管哮喘的价值。方法将2011年4月至2012年10月收治的68例重症支气管哮喘患者随机分成2组:对照组(n=34)予常规药物+鼻导管吸氧治疗;研究组(n=34)予常规药物+NIPPV治疗。以患者血气分析、肺通气功能及症状控制情况作为评价指标,比较2组患者治疗效果。结果 (1)随着治疗时间的延长两组PCO2均呈下降趋势,而PO2和pH值升高,且研究组改善的程度大于对照组(P均=0.000)。(2)治疗后两组第1秒用力呼气量占预测值的百分比(FEV1%pred)和最大呼气流速占预测值的百分比(PEF%pred)均有显著提高(与治疗前比较,P均=0.000);且治疗后研究组FEV1%pred和PEF%pred高于对照组(P=0.000)。(3)研究组临床症状控制优于对照组(P=0.003)。结论 NIPPV治疗重症哮喘可迅速改善患者血气指标和肺通气功能、控制临床症状。
Objective To evaluate the value of non-invasive bi-level positive pressure ventilation (NIPPV) in the treatment of severe bronchial asthma. Methods Sixty-eight patients with severe bronchial asthma who were admitted from April 2011 to October 2012 were randomly divided into two groups: control group (n = 34), conventional drug plus nasal catheter oxygen inhalation; study group (n = 34) Medication + NIPPV treatment. Analysis of patients with blood gas, pulmonary ventilation and symptom control as an evaluation index, the treatment effect of two groups were compared. Results (1) With the prolongation of treatment time, the PCO2 of both groups showed a decreasing trend while the PO2 and pH values increased. The degree of improvement in the study group was greater than that in the control group (P = 0.000). (2) The FEV1% pred and the maximum expiratory flow percentage (PEF% pred) in the first two seconds after treatment were significantly increased (P All = 0.000). After treatment, FEV1% pred and PEF% pred in the study group were higher than those in the control group (P = 0.000). (3) The clinical symptoms in the study group were better than those in the control group (P = 0.003). Conclusion NIPPV treatment of severe asthma can rapidly improve the patient’s blood gas index and pulmonary ventilation, control of clinical symptoms.