甘露醇雾化吸入对慢性气道疾病急性加重期化痰效果的影响

Effect of aerosol inhalation of mannitol on reducing phlegm during acute exacerbation of chronic airway diseases

目的:针对慢性气道疾病急性加重期,在传统抗感染加经口服或静脉化痰治疗的基础上,探讨甘露醇雾化吸入化痰的可行性。方法:选择支气管扩张及慢性阻塞性肺疾病急性加重期患者52例,随机分为对照组和试验组。在传统抗感染加经口服或静脉化痰治疗的基础上,给予对照组0.9%氯化钠溶液雾化吸入,给予试验组甘露醇雾化吸入。对两组的疗效及不良反应进行比较分析。结果:治疗后,试验组的痰液量和C反应蛋白(CRP)水平均低于对照组,差异有统计学意义(P<0.05)。治疗后,试验组的痰液、肺部啰音显著减少时间及住院时间均短于对照组,差异有统计学意义(P<0.05)。对照组的临床总有效率为59.26%(16/27),试验组的临床总有效率为88.00%(22/25),二者相比差异有统计学意义(P<0.05)。治疗期间,对照组中无患者出现不良反应,试验组中有2例患者发生气促、呼吸不顺畅,程度轻,吸入沙丁胺醇气雾剂后迅速缓解,无后遗症。结论:甘露醇雾化吸入对慢性气道疾病急性加重期的化痰效果可靠,能够明显改善患者的气道症状,促进痰液的排出,缩短住院时间,且安全性高,值得推广应用。

Objective:To investigate the feasibility of atomizing mannitol inhalation for resolving phlegm in acute exacerbation of chronic airway diseases on the basis of traditional anti-infection and oral or intravenous phlegm treatment.Methods:52 patients with bronchiectasis and acute exacerbation of chronic obstructive pulmonary disease were randomly divided into control group and experimental group.On the basis of traditional anti-infection plus oral or intravenous phlegm treatment,the control group was given 0.9%sodium chloride solution atomized inhalation,and the experim ental group was given mannitol atomized inhalation.The efficacy and adverse reactions of the two groups were compared and analyzed.Results:After treatment,the sputum volume and C-reactive protein(CRP)levels in experimental groups were lower than those in control group,and the differences were statistically significant(P<0.05).After treatment,the duration of sputum and lung rales decrease significantly and the length of hospital stay in the experimental group were shorter than those in the control group,with statistical significance(P<0.05).The total clinical effective rate of the control group was 59.26%(16/27),and that of the experimental group was 88.00%(22/25),the difference was statistically significant(P<0.05).During the treatment period,no patients in the control group had adverse reactions,while 2 patients in the experimental group had shortness of breath and poor breathing,with a mild degree,and were quickly relieved after inhaling salbutamol aerosol without sequelae.Conclusion:Aerosol inhalation of mannitol has a reliable phlegm reduction effect on acute exacerbation of chronic airway dis eases,which can significantly improve the airway symptoms of patients,promote the discharge of sputum,shorten the length of hospital stay,and is safe,worthy of popularization and application.