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目的探讨支气管哮喘死亡病例的临床特点、治疗手段和救治措施,以减少和避免支气管哮喘死亡病例的发生。方法收集我院2001年1月至2014年12月因支气管哮喘急性发作住院患者共1 442例,仅对其中9例死亡患者病例从3个层面进行回顾性分析(包括第一层面:入院基础信息,第二层面:入院时临床表现及发作诱因等,第三层面:实验室检查结果及治疗抢救情况)。结果 9例死亡患者中,女性7例,男性2例,年龄45~85岁,平均(65.0±13.0)岁,其中7例年龄>60岁,7例患者同时患有1种或2种以上并发症。这9例患者平素均不规律使用哮喘控制药物,均未接受过哮喘防治系统教育;支气管哮喘急性发作的主要诱发因素多为呼吸道感染;9例患者救治过程中均积极采取了吸氧、茶碱类药物及糖皮质激素静脉滴注治疗,同时均使用了抗生素药物治疗,并采取无创通气或有创通气抢救措施。结论接受哮喘防治系统教育宣传指导,密切监测病情变化,对患者有很大益处,进一步完善急性发作后的治疗和抢救措施也非常重要,有利于减少哮喘患者的死亡。
Objective To investigate the clinical features, treatment and treatment of death from bronchial asthma in order to reduce or avoid the death of bronchial asthma. Methods A total of 1 442 hospitalized patients with acute exacerbation of bronchial asthma were collected from January 2001 to December 2014 in our hospital. Only 9 of the 9 death patients were retrospectively analyzed from three aspects (including the first level: the basic information of admission , The second level: clinical manifestations and seizures incentives on admission, the third level: the results of laboratory tests and treatment of the rescue situation). Results Of the 9 patients who died, 7 were female and 2 were male, aged 45-85 years (mean, 65.0 ± 13.0 years), of whom 7 were over 60 years old and 7 had concurrent 1 or 2 concurrent disease. The 9 patients were not regular use of asthma control drugs, have not received education in the prevention and treatment of asthma; bronchial asthma acute attacks are mostly caused by respiratory infections; 9 patients were actively taken during the treatment of oxygen, theophylline Drugs and glucocorticoid intravenous infusion therapy, while using antibiotic drug treatment, and non-invasive ventilation or invasive ventilation rescue measures. Conclusions It is also very important for the patient to receive the guidance of the publicity and guidance of the education on asthma prevention and control system and closely monitor the changes of the disease. It is also very important to further improve the treatment and rescue measures after the acute attack, which will help to reduce the death of asthma patients.