可必特对伴气道阻塞支气管扩张症急性期患者的疗效观察

Curative effect of combivent on bronchiectasis with inreversible airway obstruction

目的 探讨可必特雾化吸入剂对伴气道阻塞的支气管扩张症急性期患者的治疗作用.方法 回顾性分析86例急性期支气管扩张症住院患者,入院时行肺功能提示不可逆性气道阻塞.对照组39例接受常规抗感染化痰等治疗,可必特治疗组47例,在常规治疗基础上加用可必特2.5 ml q6h氧气雾化,疗程1周.治疗前后评估2组临床症状评分,肺通气功能变化、疗效判定、不良反应差异.结果 治疗组经可必特治疗1周后临床症状评分由6.4±1.6降至2.2±1.0,对照组经常规治疗后临床症状评分由6.0±1.7降至2.8±1.5,各组患者经治疗后临床症状均明显好转（t值分别为10.2和15.5,P＜0.01）.治疗后可必特组临床症状评分2.2±1.0低于对照组2.8±1.5,二组比较差异有统计学意义（t =2.33,P＜0.05）.可必特治疗组肺通气功能FEV1％pred由治疗前（45.26±4.72）％升至（47.14±5.49）％;治疗总有效率为93.6％,平均住院天数8.2d,不良反应发生率为2.1％;对照组FEV1％pred由治疗前（48.01±5.46）％升至（51.62±4.23）％,治疗总有效率为89.7％,平均住院天数9.7d,不良反应发生率为2.6％.治疗组和对照组在肺通气功能、治疗疗效和不良反应方面差异均无统计学意义.结论 短期使用可必特对存在气道阻塞的急性期支气管扩张患者肺功能改善不明显,但在治疗过程中具有舒张气道,促进排痰、减轻临床症状的作用.

Objective To discuss the curative effect of Combivent in treating bronchiectasis with inreversible airway obstruction.Methods Retrospective analysis of 86 acute exacerbation bronchiectasis inpatients with inreversible airway obstruction verified by lung function test when admitted to hospital,were divided into 2 groups：control group （n =39） received conventional therapy and Combivent group （n =47） received combivent 2.5 ml nebulized every 6 hours a day combined with conventional therapy.The course of treatment was 1 week.The clinical symptoms,pulmonary functions,curative effect judgement and adverse effect were compared between two groups after treatment.Results Clinical symptoms were improved in Combivent group （2.2± 1.0 after treatment compared with 6.4±1.6 before treatment） and control group （2.8 ± 1.5 after treatment compared with 6.0 ± 1.7 before treatment）.There was significant difference than before treatment in each group （t =10.2 and t =15.5 respectively,P 〈0.01）.There was also significant difference between two groups （2.2 ± 1.0 in Combivent group vs 2.8 ± 1.5 in control group） after treatment （t =2.33,P 〈0.05）.FEV1 %pred was （47.14±5.49） % after treatment compared with （45.26 ± 4.72）% before treatment in Combivent group.The total effective rate is 93.6 %,mean hospitalization day is 8,2 and adverse reaction incidence is 2.1 %.While FEV1 % pred was （51.62 ± 4.23） % after treatment compared with （48.01±5.46）% before treatment in Combivent group.The total effective rate is 89.7%,mean hospitalization day is 9.7 and adverse reaction incidence is 2.6%.Lung function,curative effect and adverse effect have no difference between two groups after treatment.Conclusions Combivent has the effect of relaxing airway,accelerating sputum excretion,relieving clinical symptoms in treating acute exacerbation of bronchiectasis with inreversible airway obstruction,through it has no effect on lung function improvement in such short term usage.