复方异丙托溴铵雾化吸入联合振动排痰仪治疗慢性阻塞性肺疾病急性加重的效果研究

The effect of aerosol inhalation of compound ipratropium bromide combined with vibrating sputum expectoration in the treatment of acute exacerbation of chronic obstructive pulmonary disease

目的分析复方异丙托溴铵雾化吸入联合振动排痰仪对慢性阻塞性肺疾病急性加重(AECOPD)的治疗效果。方法我院就诊的146例AECOPD患者,根据治疗方式及患者自愿原则分为观察组和对照组各73例。对照组给予复方异丙托溴铵雾化吸入联合人工排痰治疗,观察组给予复方异丙托溴铵雾化吸入联合振动排痰仪治疗。比较两组肺部体征缓解时间、咳嗽缓解时间及住院时间;记录两组治疗前、治疗3 d及7 d时的日排痰总量;比较两组治疗7 d时的排痰有效率;比较两组治疗前及治疗7 d时的血气指标及血液炎性指标。结果观察组肺部体征缓解时间、咳嗽缓解时间及住院时间少于对照组(P<0.05);两组治疗前的日排痰量比较差异无统计学意义(P>0.05),观察组治疗3 d及7 d时的日总排痰量高于对照组(P<0.05);治疗7 d时,观察组的排痰总有效率高于对照组(P<0.05);两组治疗前的血气指标及血液炎性指标比较差异无统计学意义(P>0.05),治疗7 d时,观察组血氧分压(PaO_2)、动脉血氧饱和度(Sa O_2)高于对照组,二氧化碳分压(PaCO_2)、白细胞(WBC)计数及超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)水平低于对照组(P<0.05)。结论复方异丙托溴铵雾化吸入联合振动排痰仪治疗AECOPD可有效排痰,稳定血气指标,缓解炎性反应。

Objective To analyze the therapeutic effect of aerosol inhalation of compound ipratropium bromide combined with vibration expectoration machine in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods One hundred and forty-six patients with AECOPD treated in our hospital were selected.According to the treatment methods and the principle of patient voluntariness,the patients were divided into an observation group and a control group with 73 cases in each group.The control group was given aerosol inhalation of compound ipratropium bromide+artificial expectoration therapy,and the observation group was given aerosol inhalation of compound ipratropium bromide+vibration expectoration machine treatment.The relief time of pulmonary signs,cough relief time and hospital stay were compared between the two groups.The total amount of daily expectoration in the two groups was recorded before treatment and after 3 and 7 days of treatment.The effective rate of expectoration after 7 days of treatment and blood gas indicators and blood inflammatory indicators before treatment and after 7 days of treatment were also compared between the two groups.Results The relief time of pulmonary signs,cough relief time and hospital stay of the observation group were significantly shorter than those of the control group(P<0.05).There was no statistical significance in the amount of daily expectoration between the two groups before treatment(P>0.05),and the total amount of daily expectoration of the observation group after 3 and 7 days of treatment was significantly higher when compared to the control group(P<0.05).After 7 days of treatment,the total effective rate of expectoration was significantly better in the observation group than that in the control group(P<0.05).The blood gas indicators and blood inflammatory indicators of the two groups were balanced and comparable before treatment.After 7 days of treatment,the partial pressure of blood oxygen(PaO_(2))and arterial oxygen saturation(SaO_(2))of the observation group were significantly higher while the partial pressure of carbon dioxide(PaCO_(2)),white blood cell(WBC)count and high-sensitivity C-reactive protein(hs-CRP)and interleukin 6(IL-6)were significantly lower when compared to those of the control group(P<0.05).Conclusion Aerosol inhalation of compound ipratropium bromide combined with vibration expectoration machine can effectively expectorate sputum,stabilize the blood gas indicators,and relieve the inflammatory response in the treatment of AECOPD.