单一浓度法与梯度浓度法高渗盐水雾化诱导痰的成功率与安全性比较

Comparative study on the success rate and safety of sputum induction with hypertonic saline nebulization with single concentration and increasing concentration.

目的探讨单一浓度法和梯度浓度法高渗盐水雾化在痰诱导的成功率及安全性等方面的差异。方法对20例咳嗽变异性哮喘(CVA)患者先后以单一浓度法(3%)和梯度浓度法(3%-4%-5%)各进行1次高渗盐水的雾化痰诱导。统计两种方法的诱导成功率,观察患者在诱导期间的肺通气、心率及血氧饱和度的变化,比较痰液重量、痰细胞总数及鳞状上皮细胞比例等参数。结果单一浓度法及梯度浓度法诱导成功率分别为90%和95%;两种方法咳出的痰量、痰细胞总数和鳞状上皮细胞比例无显著差异;梯度浓度法诱导后患者的PEF及SpO2均出现下降(P<0.01),单一浓度法的PEF、HR、SpO2在诱导前后均无显著变化。结论单一浓度法和梯度浓度法均为可行及有效的痰诱导方法,但在梯度浓度法雾化过程中更需要注意患者的安全性问题。

Objective To investigate the success rate and safety of sputum induction with hypertonic saline nebulization with single concentration and increasing concentration. Methods Sputum samples induced with hypertonic saline nebulization with single concentration（3%） and increasing concentration（3%-4%-5%） were collected from 20 patients with CVA.An interval of 2 days between subsequent inductions was necessary.Changes of the peak expiratory flow（PEF）,heart rate（HR） and pulse oxygen saturation（SpO2） before and after induction were observed.The weight of sputum,total cell count and squamous cell percentage were examined. Results The success rates of sputum induced with hypertonic saline nebulization with single concentration and increasing concentration were 90% and 95%,respectively.No significant difference in quality of sputum between the two inductions was revealed.PEF and SpO2 were significantly reduced after induction with increasing concentration saline（P0.01）,while no significant change was observed with single concentration saline（P0.05）. Conclusion Hypertonic saline of 3% is as good as that of 3%-4%-5% given sequentially.However,sputum induction seems to be safer when performed with single concentration of hypertonic saline.