噻托溴铵治疗慢性阻塞性肺气肿并自发性气胸临床分析

Clinical Analysis of Ammonium Bromide in the Treatment of Chronic Obstructive Pulmonary Emphysema with Spontaneous Pneumothorax

目的观察噻托溴铵对慢性阻塞性肺气肿合并自发性气胸的临床疗效。方法选择本院2015年1月～2015年12月确诊为慢性阻塞性肺气肿并自发性气胸的患者68例，随机分为观察组与对照组各34例，对照组常规对症治疗，使用沙丁胺醇气雾剂1～2下／次，3次／天，共计2周。观察组在对照组治疗方案基础上给予噻托溴铵粉雾剂每次18μg，1次／天，干粉吸入，共计2周。观察两组患者治疗前后6min步行距离（6MWT）、住院时间、治疗2周后临床疗效以及进行胸腔闭式引流、死亡患者例数。结果经过2周治疗，观察组的显效率与总有效率明显高于对照组，均具有统计学差异（均P〈0．05）；观察组6MWT明显优于对照组，具有统计学差异（P〈0．05）；观察组住院时间为（7．18±1．06）d，明显较对照组的（11．44±2．53）d时间更少，具有统计学差异（P〈0．05）。观察组进行胸腔闭式引流的比例与死亡率均略低于对照组，但无统计学差异（均P〉0．05）。结论噻托溴铵对于慢性阻塞性肺气肿并自发性气胸具有较好的临床疗效。

Objective To observe the clinical effect of ammonium bromide in the treatment of chronic obstructive pulmonary emphysema with spontaneous pneumothormx. Methods Sixty - eight patients diagnosed with chronic obstructive pulmonary disease and spontaneous pneumothorax in our hospital from January to December 2015 were randomly divided into the observation group and the control group, with 34 cases in each group. The control group was given routine symptomatic treatment, with the use of salbutamol aerosol 1 - 2 times, 3 times a day for a full course of 2 weeks. On the basis of the con- trol group, the observation group was treated with tiotropium 18 ~g/time, 1 time a day for a total of 2 weeks. 6 minute walk- ing distance （6MWT） before and after treatment, hospitalization time, clinical efficacy after 2 -week treatments and the number of closed thoracic drainage and death cases were observed. Results After 2 weeks of treatment, the remarkable ef- fective rate and total effective rate of the observation group were significantly higher than those of control group, with statisti- cally difference （ P 〈 0. 05 ）. The 6MDT of the observation group was significantly better and its hospitalization time signifi- cantly lower than that of control group （ 11.44 ＋ 2. 53 ） d （ P 〈 0. 05 ）. The proportion of closed thoracic drainage was slightly lower than the control group, but there was no significant difference （ P 〉 0. 05 ）. Conclusion Ammonium bromide has posi- tive clinical efficacy in the treatment of chronic obstructive pulmonary emphysema with spontaneous pueumothorax.