喘可治注射液气道湿化对慢性阻塞性肺疾病急性加重期患者机械通气功能影响

Effects of Chuankezhi Injection with airway humidification on mechanical ventilation function of patients with acute exacerbation of chronic obstructive pulmonary disease

目的观察喘可治注射液持续气道湿化对慢性阻塞性肺疾病急性加重期(AECOPD)患者机械通气功能的影响。方法将80例建立人工气道的AECOPD患者随机分为治疗组和对照组,各40例;两组皆采用常规治疗(包括机械通气),同时对照组用0.45%盐水气道湿化,治疗组用喘可治(CKZ)气道内持续微泵推注气道湿化,疗程7 d。观察临床疗效,治疗前后呼吸力学指标[肺静态顺应性(Cst)、肺动态顺应性(Cdyn)、气道峰压(PIP)、平台压(Pplat)、气道阻力(Raw)]的变化及并发症的发生率。结果 (1)治疗组临床疗效总有效率为95.0%,对照组为82.5%;治疗组临床疗效优于对照组(P<0.05);(2)治疗组各呼吸力学指标改善明显优于对照(P<0.05);(3)治疗组相关肺炎、痰痂形成等并发症的发生率明显低于对照组(P<0.01)。结论对于AECOPD机械通气患者应用喘可治注射液气道内持续微泵推注湿化可明显改善患者呼吸力学,减少并发症,最终减少机械通气时间。

Objective To observe the effects of Chuankezhi （CKZ） Injection with continuous airway humidification on mechanical ventilation function of patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）. Methods Eighty AECOPD patients with artificial airway were randomly divided into the treatment group and control group ,40 cases in each group. Both groups were treated with conventional therapy （including mechanical ventilation）. Meanwhile, the control group was treated with 0.45% normal saline for airway humidification and the treatment group was treated with CKZ for continuous airway humidification by micro pump injection,with a course of 7 days. The clinical efficacy was observed, the changes of respiratory mechanics indexes that included pulmonary static compliance （ Cst ） , pulmonary dynamic compliance （ Cdyn ）, peak airway pressure （ PIP ） , platform pressure （ Pplat ） and airway resistance （ Raw ） , and the incidence of complications were compared before and after treatment. Results ①The clinical total effective rate was 95.0% in the treatment group and 82.5% in the control group. The clinical efficacy of the treatment group was better than that of the control group（ P 〈 0.05 ）. ②The improvement on all respiratory mechanics indexes in the treatment group was significantly better than that in the control group（ P 〈 0.05 ）. ③The incidence of complications such as related pneumonia and sputum scab formation in the treatment group was significantly lower than that in the control group （ P 〈 0.01 ）. Conclusion The treatment with Chuankezhi Injection for continuous airway humidification by micro pump injection can significantly improve the respiratory mechanics in AECOPD patients of mechanical ventilation, reduce the complications and ultimately reduce the time of mechanical ventilation.