小剂量肾上腺素联合布地奈德雾化吸入在慢性阻塞性肺疾病并发低氧血症患者抢救中的应用价值

Application value of low dose epinephrine combined with budesonide aerosol inhalation in the rescue of patients with chronic obstructive pulmonary disease complicated with hypoxemia

目的探讨慢性阻塞性肺疾病(COPD)并发低氧血症患者抢救中使用小剂量肾上腺素及布地奈德的价值。方法纳入50例COPD并发低氧血症患者研究(2018年4月—2021年4月),按双盲法分为对照组(n=25,采用布地奈德雾化吸入治疗)、观察组(n=25,在对照组基础上采用肾上腺素治疗),统计2组抢救成功率、临床指标、预后效果。结果(1)抢救成功率:观察组(96.00%)高于对照组(76.00%),组间对比P<0.05。(2)临床指标:观察组PaCO_(2)(43.29±4.92 mmHg)低于对照组,PaO_(2)(86.77±8.25 mmHg)、SpO_(2)(92.14±2.82%)、pH(7.43±0.12)、FVC(2.41±0.28 L)、FEV1(1.72±0.72 L)、FEV1/FVC(70.95±8.22%)高于对照组,组间对比P<0.05。(3)预后效果:观察组气喘(3.22±1.08 d)、哮鸣音(5.21±1.11 d)消失时间及住院时间(9.61±2.24 d)短于对照组,组间对比P<0.05。结论小剂量肾上腺素联合布地奈德在COPD并发低氧血症治疗中效果确切,可提高抢救成功率,亦可改善其肺功能及血气指标,值得临床参考。

Objective To explore the value of low dose epinephrine and budesonide aerosol inhalation in the rescue of patients with chronic obstructive pulmonary disease(COPD)complicated with hypoxemia.Methods Fifty patients with COPD complicated with hypoxemia(April 2018 to April 2021)were enrolled and divided into control group(n=25,treated with budesonide aerosol inhalation)and observation group(n=25,treated with epinephrine additionally)according to double-blind method.The rescue success rate,clinical indicators and prognosis of the two groups were statistically analyzed.Results(1)The success rate of rescue of the observation group(96.00%)was higher than that of the control group(76.00%,P<0.05).(2)Clinical indicators:PaCO_(2)(43.291±4.92 mmHg)in the observation group was lower than that of the control group,PaO_(2)(86.774±8.25 mmHg),SpO_(2)(92.14±2.82%),pH(7.43±0.12),FVC(2.41±0.28 L),FEV1(1.72±0.72 L),FEV1/FVC(70.95±8.22%)were higher than that in the control group(P<0.05).(3)Prognosis effect:asthma duration in the observation group(3.22±1.08 d),wheezing disappeared time(5.211±1.11 d)and hospitalization time(9.611±2.24 d)were shorter than that of the control group(P<0.05).Conclusions Low dose epinephrine combined with budesonide in the treatment of COPD complicated with hypoxemia has definite effect,which can improve the success rate of rescue,also improve lung function and blood gas index.It is worthy of clinical reference.