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目的观察双水平气道正压通气(Bi PAP)联合布地奈德雾化吸入治疗老年支气管哮喘合并Ⅱ型呼吸衰竭患者的短期疗效,为老年支气管哮喘合并呼吸衰竭的治疗提供依据。方法选取2011年11月至2015年3月在北京市回民医院呼吸科住院的老年支气管哮喘患者,应用随机数字表法,将入选患者随机分为联合治疗组和对照组,每组47例。在常规治疗的基础上,对照组仅给予布地奈德雾化吸入治疗,联合组采用Bi PAP呼吸机联合雾化吸入治疗。比较两组患者的临床疗效及氧分压(Pa O2)、二氧化碳分压(Pa CO2)、氧饱和度(Sa O2)、第1秒用力呼气容积(FEV1)、最大呼气流速峰值(PEF)、第1秒用力呼气容积占用力肺活量(FEV1/FVC)的变化情况。结果联合组有效率为91.5%,对照组为72.3%,联合治疗组疗效明显优于对照组,差异有统计学意义(χ2=5.817,P=0.016)。治疗前,两组患者的Pa O2、Pa CO2、Sa O2、FEV1、PEF及FEV1/FVC差异均无统计学意义(P>0.05);治疗后,两组患者的Pa O2、Sa O2、FEV1、PEF及FEV1/FVC均明显升高,Pa CO2明显降低,差异均有统计学意义(P<0.05)。结论 Bi PAP联合雾化吸入治疗老年支气管哮喘合并Ⅱ型呼吸衰竭患者短期疗效确切,能够改善动脉血气指标及肺功能,值得临床推广。
Objective To observe the short-term curative effect of bi-level positive airway pressure (BiPAP) combined with budesonide inhalation on elderly patients with bronchial asthma and type Ⅱ respiratory failure, and to provide basis for the treatment of elderly bronchial asthma with respiratory failure. Methods From November 2011 to March 2015, elderly patients with bronchial asthma who were hospitalized in Respiratory Department of Beijing Muslim Hospital were randomly divided into the treatment group and the control group, with 47 cases in each group. On the basis of routine treatment, the control group received only budesonide inhalation therapy, the combination group with Bi PAP ventilator combined with inhalation therapy. The clinical efficacy and the relationship between PaO2, PaCO2, SaO2, FEV1, peak expiratory flow velocity (PEF) ), Forced expiratory volume in 1 second, occupancy-induced vital capacity (FEV1 / FVC) changes. Results The effective rate was 91.5% in the combined group and 72.3% in the control group. The curative effect in the combined treatment group was significantly better than that in the control group (χ2 = 5.817, P = 0.016). PaO2, PaCO2, SaO2, FEV1, PEF and FEV1 / FVC were not significantly different between the two groups before treatment (P> 0.05). After treatment, PaO2, SaO2, FEV1, PEF and FEV1 / FVC were significantly increased, Pa CO2 was significantly lower, the difference was statistically significant (P <0.05). Conclusion Bi PAP combined with inhalation of asthma in elderly patients with type Ⅱ respiratory failure and short-term efficacy of the exact, can improve arterial blood gas index and pulmonary function, worthy of clinical promotion.