用力肺功能检查的不良反应观察及安全性探讨

Adverse reactions and safety analysis of spirometry

目的观察用力肺功能检查的不良反应及探讨其安全性。方法采用问卷调查方式对996例行用力肺功能检查的受试者进行不良反应评价。调查内容主要包括：不良反应的症状、程度、处理措施和恢复情况。结果270例（27．1％）出现了294个不良反应，其中有24例受试者同时出现2～3个不良反应。以呼吸症状发生率最高，其次为神经肌肉和咽喉部症状，其中呼吸困难129例，咳嗽79例，头晕43例，发生率分别为13．0％、7．9％、4．3％。气道阻塞组的呼吸困难发生率为33．4％，显著高于无气道阻塞组（P=0．000），并随着通气障碍的程度加重，呼吸困难的发生率逐渐增高，以极重度组发生率最高，达75．4％。轻度和中度不良反应分别占81．0％和19．0%，无重度不良反应。结论用力肺功能检查可引起不良反应的出现，但只要临床上应严格掌握检查指征，及时恰当地处理不良反应，用力肺功能检查是安全的。

Objective To investigate the adverse reactions and safety in patients who underwent spirometry. Methods Adverse reactions of 996 patients who underwent spirometry in the lung function testing laboratory were assessed by questionnaire survey. Results A total of 294 adverse reactions were present in 270 patients （27.1%）, of whom 24 subjects experienced two or three distinct adverse reactions. Tile incidence rate of adverse reactions was ordered as respiratory tr^ict symptoms, neuromyic symptoms and laryngopharyngeal symptoms, with dyspnea （129 cases, 13.0%）, coughing （79 cases, 7.9% ） and vertigo （43 cases, 4.3%） being most common. The incidence rate of dyspnea in patients with airway obstruction was significantly higher than those without airway obstruction （ P =0. 000）, and the rate increased as lung disfunction upgraded. Of 294 adverse reactions,81.0%were mild, which could be ameliorated by resting, 19.0%（56/294） belonged to moderate, which could only be recovered through clinical intervention. No severe adverse reaction was reported. Conclusions Despite that spirometry may result in certain adverse reactions, this measurement remains safe provided that indications of test were under rigorous clinical monitoring and emergency was managed in a timely manner.