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1、无创正压通气加气道给药治疗重症哮喘的临床研究作者：邵阂，鲍俊晰,杨会英，王丽，土锋单位：050011石家庄市第三医院呼吸科项H基金：河北省科技研究•发展计划项H(No.052761386)【摘要】目的探讨无创止压通气(NIPPV)加气道给药治疗重症哮喘的疗效及安全性。方法125例重症哮喘患者随机分为双水平气道正压通气(BiPAP)呼吸机治疗组(观察组，n=63)及常规治疗组(对照组，n=62),观察组常规治疗加用BiPAP,呼吸机经口鼻而罩进行NIPPV并加气道给药。対照组仅做常规治疗，比较2组患者治疗前后的临床表现、部分动脉血气、肺功能的变化。结果观察组患者症状迅速缓解，治疗4h、24
2、h后血压、心率、呼吸均有明显改善(P<0.05),治疗24h后pH值、PaCO2及FEV1%、PEF均有明显升高(PV0.05)。观察组总有效率为96.8%,明显高于对照组的77.4%；观察组平均住院天数为(10&plusnm;6)d,明显短于対照组的(17±6)d,差异均有统计学意义(P<0.05)o结论NIPPV加气道给药治疗重症哮喘疗效较快捷、明显，减少了使川令创呼吸机的概率并缩短了患者住院时间。【关键词】无创正压通气；重症哮喘；气道给药Clinicalstudyonsevereasthmatreatedbynoninvasivepositivepressureven
3、tilationcombinedwithtracheamedicationSHAOHong,BAOJunxi,YANGHuiying,etal.DepartmentofRespiratoryDiseases,TheThirdHospitalofShijiazhuangCity,Hebei,Shijiazhuang050011[Abstract]ObjectiveToinvestigatethetherapeuticeffectandsafetyofnoninvasivepositivepressureventilation(NIPPV)combinedwithtracheamedicat
4、iononsevereasthma.Methods125patientswithsevereasthmaweredividedintotwogroups.63patientsinobservationgroup,onthebasisofroutinetherapy,weretreatedbyBiPAPandnoninvasivepositivepressureventilationcombinedwithtracheamedication;theother62patientsincontrolgroupweretreatedonlybyroutinetherapy.Theclinical
5、symptoms,bloodgasandpulmonaryfunctioninpartialarteriesbeforeandaftertreatmentwereobservedandcomparedbetweenthetwogroups.ResultsThepatients'clinicalsymptomswereobviouslyrelievedinobservationgroup.Thebloodpressure,heailrateandrespirationwereobviouslyimproved4hand24haftertreatment,ascomparedwiththos
6、eincontrolgroup(P<0.05),andpH,PaCO2,FEV1%andPEFinobservationgroup24haftertreatmentweresignificantlyincreased(P<0.05).Thetotaleffectiverate(96.8%)inobservationgroupwassignificantlyhigherthanthat(77.4%)incontrolgroup(P<0.05).Themeanhospitalizationtime(10±6)dinobservationgroupwassignificantly
7、shorterthanthat(17±6)dincontrolgroup(P<0.05).ConclusionTheapplicationofNIPPVcombinedwithtracheamedicationinthetreatmentofsevereasthmacouldimproveclinicalsymptomsobviouslyandquickly,andcouldreducethepossibilityof
