糖皮质激素联合特布他林治疗慢性阻塞性肺疾病急性加重期的效果观察

Effect Observation of Glucocorticoid Combined with Terbutaline in Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的:探讨糖皮质激素联合特布他林治疗慢性阻塞性肺疾病急性加重期的效果。方法:选取2020年1月—2021年12月贵州航天医院收治的90例慢性阻塞性肺疾病急性加重期患者作为研究对象,随机分为对照组与观察组,各45例。对照组采用特布他林治疗,观察组在对照组基础上应用糖皮质激素治疗。比较两组动脉血气指标、肺功能指标、临床症状缓解时间、并发症发生情况。结果:治疗前,两组动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))水平比较,差异无统计学意义(P>0.05);治疗3 d后,观察组PaO_(2)水平高于对照组,PaCO_(2)水平低于对照组,差异有统计学意义(P<0.001)。治疗前,两组第1 s用力呼气容积(FEV_(1))、用力肺活量(FVC)、FEV_(1)/FVC水平比较,差异无统计学意义(P>0.05);治疗3 d后,观察组FEV_(1)、FVC、FEV_(1)/FVC水平均高于对照组,差异有统计学意义(P<0.05)。观察组咳嗽、咳痰、呼吸困难缓解时间短于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P=0.041)。结论:糖皮质激素联合特布他林治疗慢性阻塞性肺疾病急性加重期的效果显著,可快速缓解患者临床症状,改善患者血气指标及肺功能,降低并发症发生风险。

Objective:To explore the effect of glucocorticoid combined with terbutaline in the treatment of acute exacerbation of chronic obstructive pulmonary disease.Methods:A total of 90 patients with acute exacerbation of chronic obstructive pulmonary disease admitted to Guizhou Aerospace Hospital from January 2020 to December 2021 were selected as the study subjects.They were randomly divided into the control group and the observation group with 45 cases in each group.The control group was given terbutaline treatment,and the observation group was given glucocorticoid treatment on the basis of the control group.The arterial blood gas indexes,pulmonary function indexes,time for clinical symptom relief,and the incidence of complications were compared between the two groups.Results:There was no significant difference in the levels of arterial partial pressure of oxygen(PaO_(2))and arterial partial pressure of carbon dioxide(PaCO_(2))between the two groups(P>0.05).After 3 d of treatment,the PaO_(2)level in the observation group was higher than that in the control group,and the PaCO_(2)level in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.001).Before treatment,there were no significant differences in forced expiratory volume in 1 s(FEV_(1)),forced vital capacity(FVC),and FEV_(1)/FVC levels between the two groups(P>0.05).After 3 d of treatment,the levels of FEV_(1),FVC and FEV_(1)/FVC in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The time for the relief of cough,expectoration and dyspnea in the observation group were shorter than that in the control group,and the difference was statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P=0.041).Conclusion:Glucocorticoid combined with terbutaline has a significant effect in the treatment of acute exacerbation of chronic obstructive pulmonary disease,it can rapidly relieve clinical symptoms of patients,improve the blood gas indexes and pulmonary function of patients,and reduce the occurrence risk of complications.