中文摘要：

目的 探讨采用无创正压机械通气治疗支气管哮喘急性发作合并呼吸衰竭的疗效.方法 选取2013 年1 月至2014 年12 月首都医科大学良乡教学医院就诊的85 例支气管哮喘急性发作合并Ⅱ型呼吸衰竭患者为研究对象,按数字表法随机分为观察组42 例与对照组43 例,两组患者采用相同的基础治疗方案,对照组患者根据病情给予面罩或鼻导管吸氧;观察组加用无创正压机械通气治疗;比较两组临床疗效,观察并记录两组患者治疗前、治疗后30 min、4 h、24 h、48 h 心率（HR）、呼吸频率（RR）和动脉血气分析指标（PaO2、PaCO2、pH 值）.采用SPSS 19.0 软件进行统计分析,率的比较采用χ2 检验及校正χ2 检验,均数比较采用单因素方差分析及t 检验.结果 治疗后观察组临床疗效总有效率为90.5%,明显高于对照组的72.1%,差异具有统计学意义（χ2=4.699,P=0.030）;观察组在治疗后4 h、24 h、48 h HR、RR、PaO2、PaCO2 和pH 值均显著改善（P〈0.05）,治疗后24 h、48 h 观察组HR 和RR 与对照组比较均显著改善（P〈0.05）,治疗48 h 后观察组PaO2、PaCO2、pH 值与对照组比较均显著改善（P〈0.05）;观察组插管率为4.8%,与对照组（20.9%）比较差异具有统计学意义（P〈0.05）;观察组病死率为2.4%,与对照组（7.7%）比较差异无统计学意义（P〉0.05）;观察组住院时间与对照组比较显著缩短（P〈0.05）.结论 无创正压机械通气治疗支气管哮喘急性发作合并呼吸衰竭可显著改善患者缺氧状态及临床症状,稳定病情,效果较好.

英文摘要：

ObjectiveThis aim is to explore the efficacy of noninvasive positive pressure ventilation in the treatment of acute bronchial asthma with respiratory failure.Methods A total of 85 cases of acute bronchial asthma with typeⅡ respiratory failure patients from January 2013 to December 2014 in our hospital were selected. They were randomly divided into two groups according to number table, 42 cases of observation group and 43 cases of control group. Patients were given same basic treatment; patients in control group were given oxygen by mask or nasal cannula according to the condition, while patients in observation group were treated with noninvasive positive pressure ventilation therapy. The clinical efficacy was compared. Heart rate (HR), respiratory rate (RR) and arterial blood gas analysis (PaO2, PaCO2, pH value) before and after treatment 30 min, 4 h, 24 h, 48 h was observed. SPSS 19.0 software was used for statistical analysis, the rates were compared withχ2 test and calibrationχ2 test, and means were compared by using ANOVA andt test.Results After treatment, the clinical total effective rate of observation group was 90.5%, which was significantly higher than that in control group 72.1%, with significant difference (χ2=4.699,P=0.030). HR and RR, PaO2, PaCO2, pH values in observation group on 4 h, 24 h, 48 h after treatment were significantly improved (P<0.05), compared with control group HR and RR on 24 h, 48 h after treatment in observation group were significantly improved (P<0.05), PaO2, PaCO2, pH value on 48 h after treatment in the observation group were significantly improved (P<0.05). The intubation rate in observation group was 4.8%, while it was 20.9% in the control group, which had statistically significant difference (P<0.05). The mortality rate in observation group was 2.4%, while it was 7.7% in the control group, which had no significant difference (P>0.05). Compared with control group, the hospitalization in observation group was significantly reduced (P<0.05).Conclusion The results show