异丙托溴铵联合布地奈德呼吸机Y管雾化吸入治疗慢性阻塞性肺疾病患者急性加重期的研究

Effect of Ipratropium bromide combined with atomization inhalation of budesonide on acute exacerbation of chronic obstructive pulmonary disease

目的研究异丙托溴铵联合布地奈德呼吸机Y管雾化吸入治疗慢性阻塞性肺疾病急性加重期（AECOPD）的临床效果。方法我院2013年6月至2014年9月收治的AECOPD62例需呼吸机支持，给予气管插管的患者。间隔选择法分为两组，各31例，观察组选择雾化异丙托溴铵联合布地奈德Y管雾化，对照组选择生理盐水Y管雾化。结果观察组呼吸机气道压力（25．4±5．2）cmH2O（1cmH20--0．098kPa）、机械通气时间（6．5±1．3）d、住院ICU时间（8．9±2．1）d与对照组气道压力（38．1±3．4）cmH2O、机械通气时间（6．8±1．4）d、住院ICU时间（9．5±1．5）d，差异有统计学意义（t=10．934、0．960、1．108，P〈0．05）。观察组气管切开率为54．8％（17／31），对照组气管切开率为64．5％（20／31）。两组比较差异有统计学意义（x2=0．603，P〈0．05）。结论异丙托溴铵联合布地奈德呼吸机Y管雾化吸入治疗AECOPD有良好的疗效。

Objective To assess the clinical effects of Ipratropium bromide combined with atomization inhalation of budesonide via a ventilator with a Y shaped connector on acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. Methods A total of 62 AECOPD patients treated at our hospital from June 2013 to September 2014 were randomly divided into the experimental group （n= 31, treated with ipratropiurn bromide combined with atomization inhalation of budesonide） and the control group （n= 31, treated with the same amount of saline）. Results The airway pressure of mechanical ventilation, the time of mechanical ventilation and the time of staying in the intensive care unit all showed significant differences between the experimental and control groups （（25.4±5.2） cmH20 va. （38.1±3.4） cmH2O, （6.5±1.3） d w. （6.8±1.4） d, （8.9±2.1） d vs. （9.5±1.5） d, L=10. 934,0. 960,1. 108, respectively, P〈0.05 for all. The rate of tracheotomy was lower in the experimental group than in the control group （17/31 or 54.8% vs. 20/31 or 64.5%, X2 =0. 603, P〈0.05）. Conclusions Ipratropium bromide combined with budesonide inhalation under mechanical ventilation via a Y-shaped connector has favorable clinical effects on AECOPD.