氧气驱动雾化吸入疗法对老年人慢性支气管炎的疗效及患者生活质量的影响

Effect of oxygen-driven aerosol inhalation of anti-asthmatic drugs in the treatment of elderly patients with chronic bronchitis and its influence on the quality of life

目的观察氧气驱动雾化吸入疗法对老年人慢性支气管炎的临床疗效及患者生活质量的影响。方法选取浙江新安国际医院2015年1月至2018年1月收治的老年慢性支气管炎患者68例进行研究,按照治疗方法不同将其分为对照组与观察组各34例。对照组给予抗感染和平喘、止咳、超声雾化吸入等治疗,同时给予健康宣教和日常常规护理;观察组于平喘等常规治疗基础上实施氧气驱动雾化吸入平喘药物。记录两组患者治疗第1、2、3、4、5天时痰量;检测两组治疗期间呼吸频率、心率及血氧饱和度(SpO2);比较两组临床各项症状、体征好转情况;评价两组患者干预前后焦虑、抑郁症状、治疗依从性、主观幸福感和生活质量。结果观察组治疗第1、2、3天痰量明显多于对照组[(18.53±2.96)mL比(15.42±2.72)mL、(27.69±7.22)mL比(21.52±4.58)mL、(36.11±5.24)mL比(25.48±4.57)mL](t=4.511、4.208、8.915,P=0.000、0.000、0.000);两组治疗第4天时痰量比较差异无统计学意义(t=0.013,P=0.989);观察组治疗第5天时痰量明显少于对照组[(26.62±4.47)mL比(33.11±8.74)mL](t=3.855,P=0.000)。两组患者治疗期间呼吸频率和心率相比较,差异均无统计学意义(均P>0.05);观察组SpO2水平明显低于对照组[(92.00±3.00)%比(95.00±2.00)%](t=4.852,P=0.000)。观察组治疗后咳嗽好转时间和呼吸困难缓解时间及肺部湿啰音好转时间明显短于对照组[(2.88±0.55)d比(3.91±0.74)d、(3.17±0.62)d比(3.96±0.75)d、(3.63±0.61)d比(4.08±0.76)d](t=6.514、4.734、2.693,P=0.000、0.000、0.001)。两组患者干预后治疗依从性及生活质量评分明显高于干预前(对照组:t=7.226,P=0.000;观察组:t=18.073,P=0.000),且观察组治疗依从性及生活质量评分分别为(93.58±6.25)分、(89.63±9.88)分,升高幅度较对照组的(82.15±6.33)分、(78.93±10.22)分显著(t=7.492、4.389,P=0.000、0.000)。两组患者干预后主观幸福感评分较干预前显著下降(对照组:t=10.338、4.474,P=0.000、0.000;观察组:t=16.354、8.939,P=0.000、0.000),观察组下降幅度更大(t=13.936,P=0.000)。结论氧气驱动雾化吸入平喘药物治疗老年慢性支气管炎具有较好的化痰止咳效果,同时还可保障氧气吸入以提高氧分压,加速患者病情好转,稳定患者情绪,提高其自信心,进而提高其治疗依从性,提高其生活质量和幸福感。

Objective To investigate the effect of oxygen-driven aerosol inhalation of anti-asthmatic drugs in the treatment of elderly patients with chronic bronchitis and its influence on the quality of life.Methods From January 2015 to January 2018,68 elderly patients with chronic bronchitis in Zhejiang Xin'an International Hospital were randomly selected and divided into control group and observation group according to different treatment methods,with 34 cases in each group.The control group was given anti-infective,relieving cough and asthma,ultrasonic atomized inhalation and other treatments,meanwhile oral health education and routine care were also given.The observation group was implemented oxygen-driven aerosol inhalation of anti-asthmatic drugs based on the control group.The phlegm quantity of the two groups was recorded on the 1st,2nd,3rd,4th and 5th day of treatment.The respiratory rate,heart rate and SpO2 were measured during the treatment period.The improvements of clinical symptoms and signs were compared.The anxiety,depressive symptoms,treatment adherence,subjective well-being and quality of life of the two groups before and after intervention were evaluated.Results The amount of sputum in the observation group was significantly higher than that in the control group on day 1,2 and 3[(18.53±2.96)mL vs.(15.42±2.72)mL,(27.69±7.22)mL vs.(21.52±4.58)mL,(36.11±5.24)mL vs.(25.48±4.57)mL](t=4.511,4.208,8.915,P=0.000,0.000,0.000).At the 4th day after treatment,the amount of sputum had no statistically significant difference between the two groups(t=0.013,P=0.989).At the 5th day after treatment,the amount of sputum in the observation group was significantly less than that in the control group[(26.62±4.47)mL vs.(33.11±8.74)mL](t=3.855,P=0.000).The respiratory rate and heart rate had no statistically significant differences between the two groups during treatment(all P>0.05).The SpO2 level in the observation group was significantly lower than that in the control group[(92.00±3.00)%vs.(95.00±2.00)%](t=4.852,P=0.000).The cough improvement time,dyspnea relief time and the improvement time of lung wet snoring sound in the observation group were significantly shorter than those in the control group[(2.88±0.55)d vs.(3.91±0.74)d,(3.17±0.62)d vs.(3.96±0.75)d,(3.63±0.61)d vs.(4.08±0.76)d](t=6.514,4.734,2.693,P=0.000,0.000,0.001).The treatment adherence and quality of life scores of the two groups after intervention were significantly higher than before intervention(control group:t=7.226,P=0.000;observation group:t=18.073,P=0.000).The scores of treatment adherence and quality of life in the observation group were(93.58±6.25)points and(89.63±9.88)points,which were significantly higher than those in the control group[(82.15±6.33points and(78.93±10.22)points](t=7.492,4.389,P=0.000,0.000).The subjective well-being scores of the two groups after intervention were significantly lower than before intervention(control group:t=10.338,4.474,P=0.000,0.000;observation group:t=16.354,8.939,P=0.000,0.000),the decline of the observation group was more significant compared with the control group(t=13.936,P=0.000).Conclusion Oxygen-driven aerosol inhalation of anti-asthmatic drugs has good antispasmodic and antitussive effect in the treatment of elderly patients with chronic bronchitis.At the same time,oxygen inhalation can be guaranteed to increase the oxygen partial pressure,accelerate the patients’condition,stabilize the patients’mood and improve the patients’self-confidence,thereby improving its treatment compliance,better control the disease to improve their quality of life and happiness.