经纤维支气管镜肺泡表面活性物质灌洗治疗AECOPD的临床评价

Clinical Therapeutic Evaluation of Bronchchoalvelar Lavage with Pulmonary Surfactant in Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的：评价经纤维支气管镜（纤支镜）肺泡表面活性物质灌洗治疗慢性阻塞性肺疾病急性加重期（AECOPD）的临床疗效。方法：选择符合标准的40例AECOPD住院患者,随机分为常规治疗组（Ⅰ组,n=15）和灌洗组（Ⅱ组,n=25）,II组在常规治疗组基础上于住院后第1－3 d进行肺泡表面活性物质灌洗治疗,两组分别于入院时和治疗后第5、7 d行动脉血气分析,肺功能检查,并进行临床症状综合评价。结果：Ⅱ组及Ⅰ组治疗后的FEV1、FEV1/FVC、PaO2、PaCO2临床症状均明显改善（P〈0.05）,Ⅱ组较Ⅰ组改善显著（P〈0.05）。结论：纤维支气管镜肺泡表面活性物质灌洗治疗AECOPD疗效确切,安全可靠,易于推广。

Objective：To investigate the effects of bronchcho-alvelar lavage with pulmonary surfactant by bronchoscopy in the treatment of acute exacerbation of chronic obstructive pulmonary disease（AECOPD）.Methods：40 patients with AECOPD were divided into two groups.Randomly assigned to standard medical treatment group（group Ⅰn=15） and the group（group Ⅱ n=25）of lung lavage with pulmonary surfactant.Lung lavage was performed in the group II on the three days prior to admission.Arterial blood gases,lung function and comprehensive assesment of clinical data were observed before and on the 5th、7th day after treatment.Results：The levels of FEV1、FEV1/FVC、PaO2、PaCO2 and clinical symptoms were markedly improved inⅠ,Ⅱgroup.GroupⅠandⅡhad statistically significant difference in the two group（P〈0.05）.Conclusions：Lung lavage by bronchoscopy with pulmonary surfactant was a safe and effectual way and easy to popularize in the treatment of AECOPD.