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目的 :通过危重型哮喘患者机械通气应用的分析 ,探讨机械通气在危重型哮喘中的应用与时机。方法 :将入选病人根据机械通气情况分为延迟机械通气组 (n =16,出现危重型哮喘 2 4h以后 ,男 5例 ,女 11例 )及时机械通气组 (n =9,出现危重型哮喘 2 4h以内 ,男 3例 ,女 6例 )。所有病人均在常规治疗的基础上行机械通气。观察患者的年龄、性别、病情严重度、入院时的生理指标、机械通气的上机时机和治疗转归 ,比较两组患者的存活率、住院时间及机械通气时间。结果 :Ⅰ组存活 7例 ,存活率 43 75 % ,Ⅱ组存活 9例 ,存活率 10 0 % ,两者存活率比较Ⅱ组显著高于Ⅰ组 (P <0 0 5 )。Ⅰ组出现并发症气胸 1例 ,肺部感染 4例 ,上消化道出血 1例 ,肾功能不全 1例 ,而Ⅱ组未出现并发症。Ⅰ组机械通气时间为 (5 83± 3 0 4)d ,Ⅱ组为 (2 89± 1 69)d ,两组相比 ,Ⅰ组机械通气时间显著长于Ⅱ组 (P <0 0 5 ) ;Ⅰ组住院时间为 (12 0 0± 7 65 )d ,Ⅱ组为 (5 3 3± 1 87)d ,两组比较 ,Ⅰ组住院时间显著长于Ⅱ组(P <0 0 5 )。结论 :对于危重型哮喘病人 ,早期机械通气可以有效减少患者的病死率和并发症的发生率 ,缩短机械通气的时间和住院时间。
Objective: To explore the application and timing of mechanical ventilation in critical asthma by analyzing the application of mechanical ventilation in critically ill asthmatic patients. Methods: The selected patients were divided into delayed mechanical ventilation group (n = 16, 5 cases of male and 11 female) after mechanical ventilation group (n = 16, severe acute asthma 2 Within 4h, 3 males and 6 females). All patients underwent routine mechanical ventilation. Observe the patient’s age, gender, severity of the disease, physiological indicators at admission, the opportunity of mechanical ventilation and treatment outcome. The survival rate, hospital stay and mechanical ventilation time were compared between the two groups. Results: Survival rate was 43 75% in group Ⅰ, 9 in group Ⅱ and 10 0% in group Ⅱ. The survival rate in group Ⅱ was significantly higher than that in group Ⅰ (P <0.05). Complications in group Ⅰ pneumothorax in 1 case, pulmonary infection in 4 cases, 1 case of upper gastrointestinal bleeding, renal insufficiency in 1 case, while no complications in group Ⅱ. The duration of mechanical ventilation in group Ⅰ was significantly higher than that in group Ⅱ (P <0.05). The duration of mechanical ventilation in group Ⅰ was (583 ± 3) 4 days and in group Ⅱ was (299 ± 1) The duration of hospital stay in group Ⅰ was (12 0 ± 7 65) d, and in group Ⅱ was (53 ± 1 87) d. The length of stay in group Ⅰ was significantly longer than that in group Ⅱ (P <0.05). Conclusions: For critically ill asthmatic patients, early mechanical ventilation can effectively reduce the incidence of mortality and complications and shorten the duration of mechanical ventilation and hospital stay.