慢性阻塞性肺疾病急性加重期患者规范化痰诱导安全性的初步研究

Safety of sputum induction in subjects with acute exacerbations of chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者进行高渗盐水痰诱导的安全性。方法制定规范化操作流程,对22例重度、极重度AECOPD患者进行痰诱导,在诱导过程中严密监测患者第一秒用力呼气容积(FEV1)和脉搏容积血氧饱和度(SpO2)的变化。结果22例AECOPD患者在诱导前SpO2为(93.8±0.9)%,结束时SpO2为(91.7±0.8)%,较基础值下降了(2.1±0.4)%(P<0.01),结束后10min,SpO2恢复至基础值水平;诱导前FEV1为(0.70±0.19)L,结束时为(0.62±0.17)L,FEV1较基础值下降了(12.3±3.1)%(P=0.027),结束后10min,FEV1恢复至基础值水平。共有19例患者渡过了整个痰诱导过程,成功率为86%。结论在严密监控下,使用规范化的痰诱导流程,痰诱导法对AECOPD患者是一种比较安全的方法。

Objective To evaluate the safety of sputum induction in subjects with acute exacerbations of chronic obstructive pulmonary disease(AECOPD). Methods Twenty-two patients with AECOPD were enrolled in the study. All subjects inhaled a mist of 3% hypertonic saline solution and the forced expiratory volume in one second(FEV_1) and pulse oxygen saturation(SpO_2) were measured during the procedure. Results A significant fall in SpO_2 and FEV_1 was found during sputum induction by inhalation of 3% hypertonic saline solution. Mean decline in SpO_2 during sputum induction was (2.1±0.4)%(P<0.01) and recovered within 10 min after cessation of sputum induction. Mean decline in FEV_1 during sputum induction was (12.3±3.1)%(P=0.027),an absolute fall of (0.11±0.03)L,and the FEV_1 returned to the baseline in all subjects within 10 min after cessation of sputum induction. The sputum induction was successful in 19 of the 22(86%) patients. Conclusion The use of a standardized sputum induction protocol is relatively safe in sampling the lower airways in patients with AECOPD.