Analysis of Influencing Factors of Moderate to Severe Malnutrition in Elderly Patients with Lung Cancer during Chemotherapy

Objective:This study aims to identify the factors influencing moderate to severe malnutrition in elderly lung cancer patients undergoing chemotherapy and to provide a basis for developing clinical prevention and intervention strategies.Methods:The clinical data of 150 elderly lung cancer patients who received chemotherapy were retrospectively analyzed.Demographic data,clinical characteristics,laboratory indicators,treatment plans,and other relevant information were collected.Independent risk factors for moderate to severe malnutrition during chemotherapy were identified.Results:During chemotherapy,50 patients(33.33%)developed moderate to severe malnutrition.The BMI of patients with moderate to severe malnutrition was significantly lower than that of patients with no or mild malnutrition(21.20±1.60 vs.26.14±2.31,P<0.001),and the proportion of patients with stage IV tumors was significantly higher(60.00%vs.27.00%,P<0.001).Serum pre-albumin(pre-ALB)and hemoglobin(Hb)levels in patients with moderate to severe malnutrition were significantly lower than those in patients with no or mild malnutrition(152.67±30.41 g/L vs.252.47±51.24 g/L and 102.44±10.09 g/L vs.154.21±15.18 g/L,respectively,P<0.001 for all).Conclusion:Low BMI,decreased serum pre-ALB levels,and decreased serum Hb levels before chemotherapy are independent risk factors for moderate to severe malnutrition in elderly lung cancer patients during chemotherapy.Close clinical attention should be given to these patients,with early intervention measures such as nutritional support to reduce the incidence of malnutrition and improve patients’quality of life and prognosis.

Application of Quality Control Circle Activity in Improving Effectiveness of Drug Intervention in Lung Cancer Patients with Moderate to Severe Pain

Objective:Lung cancer has the highest incidence and mortality of all malignant tumors in China.Cancer pain dramatically affects patients’comfort level,causing insomnia,anorexia,anxiety,fear,depression,and a decline in the quality of life(QOL).The literature suggests a shortage of adequate cancer pain management for 59.1% of patients in China.The quality control circle(QCC)activity reflects the people-oriented core idea of management.This study aimed to assess the efficacy of QCC in enhancing the effectiveness of drug interventions in lung cancer patients with moderate to severe pain.Methods:From January 2019 to July 2019,lung cancer patients with moderate to severe pain were treated with drugs.The total number of drug interventions was 3072.A QCC activity was performed following the ten steps of the plan-do-check-act(PDCA)model.The reasons for the poor effectiveness of drug intervention in lung cancer patients with moderate to severe pain were analyzed.Countermeasures were designed to improve the effectiveness of drug intervention,including setting up a pain college,writing a medication education manual,and formulating operational rules for the administration of narcotic drugs.The effectiveness of drug intervention in lung cancer patients with moderate to severe pain and activity ability scores of QCC members were analyzed statistically before and after QCC activity.The effectiveness of drug intervention was investigated and compared before and after establishing the QCC.Results:After establishing the PDCA model,the effectiveness of drug intervention for moderate to severe pain in lung cancer patients increased from 56.28% to 85.29%.Members had significant improvement in problem-solving ability,responsibility,communication,coordination,self-confidence,team cohesion,enthusiasm,QCC skills,and harmony.Conclusion:QCC activity can significantly improve the efficiency of drug intervention in lung cancer patients with moderate to severe pain and their quality of life.

Clinical Observation on Treatment of Moderate and Severe Periodical Mastalgia with TCM Hot-wet Compress Therapy

[Objectives] To observe the clinical therapeutic efficacy of local hot-wet compress therapy of digestion ointment prescription on the patients with moderate and severe mastalgia. [Methods] Firstly,60 patients with mastalgia were selected,and divided into the experimental group and control group( 30 cases for each group). The control group was treated with acupuncture at distal point,and the experimental group was treated with TCM local hot-wet compress therapy combined with acupuncture at distal point. Then,the clinical therapeutic efficacy of two groups was compared. [Results]The experimental group was superior to the control group in relieving the breast pain,improving emotional integral,reducing breast lumps,improving lump texture,and improving TCM syndrome integral( P < 0. 05). [Conclusions]The digestion ointment prescription local hot-wet compress therapy has a significant therapeutic effect on treatment of mastalgia and can significantly improve the breast pain symptom of patients.

Clinical, laboratory and radiological features and outcomes of moderate to severe COVID-19 patients: A descriptive retrospective study

Objective:To describe the clinical,laboratory and radiological characteristics and outcomes of moderate-to-severe coronvirus disease 2019(COVID-19)patients.Methods:We retrospectively analyzed 43 RT-PCR confirmed moderate-to-severe COVID-19 patients who were admitted to a tertiary care center.The primary composite outcomes were admission to intensive care unit,requirement of mechanical ventilation,and death.Results:The median age of the patients was 50 years,and 62.8%of the patients were male.Out of 43 patients,15(34.88%)were categorized as severe.A total of 26(60.47%)patients had 1 or more comorbidities[diabetes(34.88%)and hypertension(30.23%)].The median duration from the onset of symptoms to admission was 3 days,and the most common symptoms were dyspnoea(90.7%),cough(79.07%),fever(69.77%),and body ache(46.51%).Leucopenia was presented in 14(32.56%)patients,lymphopenia in 26(60.47%)patients,and monocytosis in 7(16.28%)patients.Besides,40(93.02%)patients had bilateral patchy nodular or interstitial infiltration on chest X-ray.The primary outcomes occurred in 20 patients(46.5%),among whom 8 required mechanical ventilation.The patients who had met the primary outcomes were older.They were prone to have at least 1 comorbidity(P=0.004),diabetes(P=0.01),hypertension,higher sequential organ failure assessment score,more tachycardia,lower SpO2,lower PaO2/FiO2,more thrombocytopenia,and more pancytopenia.Conclusions:This retrospective study identified several risk factors for poor outcomes in adults with COVID-19.In particular,older age,tachycardia,high SOFA score,low SpO2,low PaO2/FiO2,presence of comorbidities in form of diabetes and hypertension,thrombocytopenia,and pancytopenia at admission were associated with higher odds of ICU admission,a requirement of mechanical ventilation and in-hospital death.

Effects of modified pulmonary rehabilitation on patients with moderate to severe chronic obstructive pulmonary disease:A randomized controlled trail

Objectives:This study aimed to assess the effects of modified pulmonary rehabilitation(PR)on patients with moderate to severe chronic obstructive pulmonary disease(COPD).Methods:A total of 125 patients(63 in the PR group and 62 in the control group)were recruited in this study.The patients in the PR group received 12 weeks of conventional treatment,nursing,and modified pulmonary rehabilitation,while the patients in the control group underwent 12 weeks of conventional treatment,nursing,pursed-lip breathing training,and abdominal breathing training.Baseline characteristics,St.George's Respiratory Questionnaire(SGRQ),the six-minute walk test(6MWT),modified medical research council(MMRC)dyspnea scale,and lung function were compared between the two groups.Results:A total of 112 patients(58 patients in the PR group and 54 patients in the control group)completed the 12-week monitoring and follow-up.The SGRQ scores,symptoms(54.933±11.900),activity(52.644±14.334),impact(55.400±9.905),and total score(54.655±10.681)of the PR group did not significantly differ in pre-and post-treatments(P<0.05).No significant change was also observed in the control group(P>0.05).6MWT[(372.089±67.149)m]was significantly improved in the PR group(P<0.05)but was not significantly different in the control group(P>0.05).MMRC(actual rank sum 1719,rank sum 2047.5)was significantly reduced in the PR group(P<0.05)but not in the control group(P>0.05).The lung function(FVC,FEV1,FEV1/FVC,FEV1%and PEF)of the patients in both groups did not significantly change(P>0.05).Conclusion:Modified PR reduces the symptoms of dyspnea,increases exercise capacity,and improves the quality of life of patients with moderate to severe COPD.

Effect of acupoint application combined with microwave treatment on the intestine barrier functional disturbance of moderately severe acute pancreatitis

Objective: To explore and analyze the effect of acupoint application combined with microwave treatment on the intestinal barrier dysfunction with moderately severe acute pancreatitis. Methods: A convenient sample of 90 moderately severe acute pancreatitis was selected from March 2017 to December 2017 in the comprehensive hospital with third grade in Tianjin. The patients were divided into group A (acupoint application combined with microwave treatment), group B (acupoint application) and group C (routine nursing). Thirty patients were included in each group. This study need to get the informed consent of the patients. Acupoint application combined with microwave treatment was used, basing on routine nursing measures in group A. Acupoint application was used by the same way and the same traditional Chinese medicine ,basing on routine nursing measures in group B. Routine nursing used in group C. C-reactive protein and the score of intestinal function were measured on 3 th day, 7 th day and 10 th day, after intervention. To record the effective ratio of the treatment after 10 days of intervention. Results: There are significant statistical difference among the three group after intervention (P < 0.05). Conclusion: In some way, acupoint application combined with microwave treatment are able to decrease the time about the recovery of intestinal barrier dysfunction in moderately severe acute pancreatitis and to alleviate the suffering of patients.

Effect of Chaishao Chengqi Decoction on inflammation and prognosis of moderate and severe acute pancreatitis of heat stagnation and Fu-organ excess type

Objective:To explore the curative effect of Chaishao Chengqi Decoction on moderate to severe acute pancreatitis of heat stagnation and Fu-organ excess type and its effect on inflammatory reaction,and to provide new ideas for clinical treatment and prognosis evaluation.Methods:60 patients with moderate to severe acute pancreatitis of heat stagnation and Fu-organ excess type from June 2017 to June 2019 were randomly divided into control group treated with conventional therapy and treatment group treated with Chaishao Chengqi Decoction for 2 weeks.The differences of clinical efficacy and TCM syndromes between the two groups were compared.Ranson score,Balthazar CTSI score,SIRS score and modified Marshall score were recorded before and after treatment.The levels of inflammatory factors and oxidative stress-related molecules were compared before and after treatment.Result:After treatment,the total effective rates of the control group and the treatment group were 80.0%and 93.3%,respectively,with statistical difference(χ2=8.845,P=0.027);after treatment,the total effective rates of TCM syndromes evaluation of the control group and the treatment group were 76.7%and 93.3%,respectively,with statistical difference(χ2=10.024,P=0.012);after treatment,the Ranson score,Balthazar CTSI score,SIRS score and improved Marshall score were all significantly decreased(P<0.05),and the decrease was more significant in the treatment group(P<0.05);after treatment,the serum levels of TNF-α,IL-6 and MDA were significantly decreased in both groups,and superoxide dismutase(SOD)was significantly increased(P<0.05),and the treatment group improved more(P<0.05).Conclusion:Chaishao Chengqi Decoction has a good curative effect on moderate to severe acute pancreatitis of heat stagnation and Fu-organ excess type,and can effectively improve inflammatory response and oxidative stress,which has a high clinical significance.

Efficacy and Safety of 30% Supramolecular Salicylic Acid Peeling Combined with Isotretinoin Erythromycin Gel in the Treatment of Moderate-to-Severe Acne Vulgaris: A Comparative Study

Background: Both 30% supramolecular salicylic acid (SA) and isotretinoin erythromycin gel (IEG) have proven efficacy with good safety profiles in the treatment of acne vulgaris. Objectives: This study compared the clinical efficacy and safety of 30% SA peeling and IEG in the treatment of moderate-to-severe acne vulgaris. Methods: Patients with moderate-to-severe acne vulgaris were randomized into 3 groups of 30 persons each, and treated with SA peel, or IEG, or SA combine with IEG (SA + IEG group). Evaluation of acne was done by effective rate and individual lesion counts. And the adverse effects and recurrence were recorded. Results: The SA + IEG group was better in clinical efficacy and treating noninflammatory and inflammatory lesions than that of single treatment group (P 0.05). Conclusion: 30% SA combined with IEG had a significant effect in the treatment of moderate-to-severe acne lesions.

Study on difference between intravascular cooling system and traditional moderate hypothermia in patients with severe traumatic brain injury

Objective To study difference between intravascular cooling system and traditional moderate hypothermia in patients with severe traumatic brain injury. Methods Eighty sTBI patients were randomly divided into intravascular hypothermic groups (IVT) and traditional moderate hypothermia groups(HT) . Inclusion criteria included a Glasgow Coma Scale(GCS) score ≤8 and time from injury to admission must be within 12 hours.

Effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe pneumonia

Objective: To discuss the effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe pneumonia. Methods: A total of 68 patients with COPD complicated by severe pneumonia who were treated in the hospital between November 2015 and April 2017 were collected, retrospectively analyzed and then divided into the group A (n=35) who received noninvasive positive pressure ventilation and the group B (n=33) who received lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation. The differences in arterial blood gas and serum index levels were compared between the two groups before and after treatment. Results: Before treatment, there was no statistically significant difference in arterial blood gas index levels as well as serum contents of inflammatory mediators, stress hormones and myocardial enzyme spectrum indexes between the two groups. After treatment, arterial blood gas indexes PH and PaO2 levels of group B were higher than those of group A;serum inflammatory mediators HMGB1, PCT and hs-CRP contents were lower than those of group A;serum stress hormones Cor, AngⅠ and AngⅡcontents were lower than those of group A;serum myocardial enzyme spectrum indexesα-HBDH and cTn-Ⅰ contents were lower than those of group A. Conclusion: Lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation can effectively optimize the arterial blood gas levels, reduce systemic inflammatory stress state and protect the myocardial function of patients with COPD complicated by severe pneumonia.

重症肺结核合并COPD患者机械通气死亡结局的影响因素分析

目的探讨研究重症肺结核合并慢性阻塞性肺疾病(Chronic Obstructive Pulmoriary Disease,COPD)患者机械通气死亡结局的影响。方法回顾性分析2020年5月-2021年5月福建省漳州市医院呼吸内科、感染科重症病房收治的60例重症肺结核合并COPD患者的临床资料,均进行机械通气治疗,后根据患者最终结局进行分组,其中40例成功生存患者,纳入生存组,20例最终病死患者,纳入病死组,对比两组患者一般资料、治疗情况、实验室指标、CT影像,分析出造成患者病死的相关危险因素。结果两组重症病房住院时间、插管时间、系统或器官功能障碍、耐多药肺结核、呼吸机相关性肺炎、呼吸机后气胸、肺大泡及肺损坏程度比较,差异有统计学意义(P均<0.05);多因素Logistic回归分析显示,重症病房住院时间、耐多药肺结核、呼吸机相关性肺炎,均是重症肺结核合并COPD患者行机械通气治疗后出现病死的独立危险因素(OR=1.063、4.623、3.967,P均<0.05)。结论耐多药肺结核、呼吸机相关性肺炎均是重症肺结核合并COPD患者行机械通气治疗后死亡的相关因素。

Frequency and Profile of Severe Periodontitis in Kinshasa Dental Hospitals, DR Congo

Purpose: Severe periodontitis (SP) is the sixth most prevalent disease world-wide. Prevalence and incidence are poorly reported in DR Congo. The aim of this study was to assess the prevalence of SP and to compare its profile with that of mild to moderate periodontitis (MMP). Materials and Methods: Four hundred and four patients from four hospitals of Kinshasa City Capital participated in this study. Probing pocket depth (PPD) at six sites per tooth, bleeding on probing (BoP) and plaque index (PIl) were the main clinical parameters assessed. Results: Out of 404 patients examined in this study, 92 (22.8%) had severe periodontitis and 276 (68.3%) had mild to moderate periodontitis. Among patients with SP, 48 (52%) were female, 44 (48%) were male and 63% of them had a PPD of 6 mm. SP was significantly different from MMP according to patients age, 47.3 ± 18.6 versus 32.87 ± 14.40 years old, p < 0.001;plaque index, 1.153 ± 0.39 versus 0.90 ± 0.39, p < 0.001;BoP, 26.65 versus 17.04, p < 0.001. Conclusion: The Frequency of SP is relatively high in patients attending dental services in Kinshasa City and SP is significantly different from MMP.

白葡奈氏菌片联合ICS+LABA治疗中重度COPD急性发作

目的探究及观察白葡奈氏菌片联合吸入糖皮质激素+长效β2受体激动剂(inhaled corticosteroid+long-acting β_(2)-agonist,ICS+LABA)治疗中重度慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)急性发作的疗效及对生活质量的影响。方法将2020年6月—2021年12月山东第一医科大学附属省立医院的80例中重度COPD急性发作患者根据随机数字表法分为2组。对照组的40例采用ICS+LABA进行治疗,观察组的40例则在对照组的基础上加用白葡奈氏菌片。比较2组的COPD治疗总有效率、不良反应发生率、治疗前后的症状体征积分、疾病状态[慢性阻塞性肺疾病评分(COPD assessment test,CAT评分)]及生活质量[世界卫生组织生存质量测定量表简表(World Health Organization on quality of life brief scale,WHOQOL-BREF评分)]。结果治疗1、2周后观察组的COPD治疗总有效率显著高于对照组,差异有统计学意义(P<0.05),2组的不良反应发生率比较,差异无统计学意义(P>0.05),治疗1、2周后观察组的COPD相关症状体征积分显著低于对照组,CAT评分构成则显著优于对照组,WHOQOL-BREF评分显著高于对照组,差异有统计学意义(P<0.05)。结论白葡奈氏菌片联合ICS+LABA治疗中重度COPD急性发作的疗效较好,且可显著改善患者的生活质量。

布地奈德福莫特罗、布地格福吸入气雾剂治疗中重度COPD的疗效及对肺功能的影响

目的研究布地奈德福莫特罗、布地格福吸入气雾剂在重度慢性阻塞性肺疾病(COPD)治疗应用中的疗效及对肺功能的影响。方法选取120例中重度COPD患者作为研究对象。以随机分组法将120例患者均分为对照组和观察组,各60例。其中观察组的治疗方式为布地格福吸入气雾剂治疗,对照组的治疗方式为布地奈德福莫特罗吸入气雾剂治疗。比较治疗前、治疗后1个月两组患者肺功能常规指标、血气分析、疗效、不良反应、生活质量。结果①治疗1个月后,观察组患者FVC、FEV1、FEV1%均高于对照组(P<0.05);②治疗1个月后,观察组患者PaO_(2)、SaO_(2)、pH高于对照组,PaCO_(2)低于对照组(P<0.05);③治疗1个月后,观察组患者临床疗效优于对照组(P<0.05);不良反应比较差异无统计学意义(P>0.05);④两组患者生活质量得分均有降低(P<0.05),且观察组分数优于对照组(P<0.05)。结论布地格福吸入气雾剂治疗相比于布地奈德福莫特罗吸入气雾剂治疗对于中重度COPD患者而言更能有利于促进其肺功能的恢复、改善其血气情况、疗效明显、安全性高、有助于患者生活质量改善,值得推广。目的研究布地奈德福莫特罗、布地格福吸入气雾剂在重度慢性阻塞性肺疾病(COPD)治疗应用中的疗效及对肺功能的影响。方法选取120例中重度COPD患者作为研究对象。以随机分组法将120例患者均分为对照组和观察组,各60例。其中观察组的治疗方式为布地格福吸入气雾剂治疗,对照组的治疗方式为布地奈德福莫特罗吸入气雾剂治疗。比较治疗前、治疗后1个月两组患者肺功能常规指标、血气分析、疗效、不良反应、生活质量。结果①治疗1个月后,观察组患者FVC、FEV1、FEV1%均高于对照组(P<0.05);②治疗1个月后,观察组患者PaO_(2)、SaO_(2)、pH高于对照组,PaCO_(2)低于对照组(P<0.05);③治疗1个月后,观察组患者临床疗效优于对照组(P<0.05);不良反应比较差异无统计学意义(P>0.05);④两组患者生活质量得分均有降低(P<0.05),且观察组分数优于对照组(P<0.05)。结论布地格福吸入气雾剂治疗相比于布地奈德福莫特罗吸入气雾剂治疗对于中重度COPD患者而言更能有利于促进其肺功能的恢复、改善其血气情况、疗效明显、安全性高、有助于患者生活质量改善,值得推广。

抗心磷脂抗体水平与COPD合并肺炎严重程度的关系

目的分析抗心磷脂抗体(Anticardiolipin Antidody,ACA)水平与慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease,COPD)合并肺炎严重程度的关系。方法选取2022年5月—2023年5月北京市大兴区人民医院收治的88例COPD患者作为研究对象,根据患者是否合并肺炎,将患者分为COPD组(61例)和COPD合并肺炎组(27例)。入院时取其血清样本,采用酶联免疫吸附法检测血清ACA水平,采用Spearman相关性分析法分析血清ACA与COPD合并肺炎严重程度的关系。结果COPD合并肺炎组患者吸烟史、机械通气、C-反应蛋白、降钙素原、COPD分期均高于COPD组患者,差异有统计学意义(P均<0.05),用力肺活量(Forced Vital Capacity,FVC)、1秒率低于COPD组患者,差异有统计学意义(P均<0.05)。COPD组合并肺炎患者血清ACA水平(5.27±1.22)RU/mL高于COPD组的(2.43±0.56)RU/mL,并且血清ACA水平随COPD分期增加而逐渐升高,组间两两比较,差异具有统计学意义(P均<0.05)。Spearman分析结果显示,血清ACA与C-反应蛋白、降钙素原、COPD分期呈正相关关系(P均<0.01);血清ACA与FVC、FEV1/FVC呈负相关关系(P均<0.01)。结论COPD合并肺炎患者血清ACA水平降低,抗心磷脂抗体与COPD合并肺炎严重程度呈正相关关系,对患者病情严重程度评估具有重要参考价值。

低密度脂蛋白与淋巴细胞的比值对COPD患者严重程度和预后的预测价值

目的 分析低密度脂蛋白与淋巴细胞的比值(Low Density Lipoprotein/Lymphocyte,LDL/LYM)对慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease,COPD)患者病情严重程度和预后的预测价值。方法 选取2020年3月—2022年9月无锡市第八人民医院的80例COPD患者作为研究组,另选同期入院体检的健康志愿者80例作为对照组,对比两组低密度脂蛋白(Low Density Lipoprotein,LDL)、淋巴细胞(Lymphocyte,LYM)及LDL/LYM值。再根据COPD患者病情严重程度将其分成4组,轻度组(n=17)、中度组(n=19)、重度组(n=20)、极重度组(n=24),对比4组LDL、LYM、LDL/LYM值,并分析LDL、LYM、LDL/LYM值与COPD患者病情严重程度及预后发展的关系。结果 COPD患者LDL、LDL/LYM随着病情严重程度增加而增加,而LYM随着病情严重程度增加而降低,差异有统计学意义(P均<0.05)。经ROC曲线面积分析发现,LDL、LYM、LDL/LYM值的AUC分别为0.798、0.751、0.854,提示LDL/LYM值对COPD患者预后不佳的预测价值更高(P均<0.05)。结论 LDL/LYM值对COPD患者具有较高的临床价值,能有效评估其病情严重程度并预测COPD患者预后不佳的风险。

肢体运动训练对老年中重度COPD患者肺功能和生活质量改善的影响

目的:分析老年中重度慢性阻塞性肺疾病(COPD)患者实施肢体运动训练对患者肺功能、生活质量改善的影响。方法:本研究选取2021年1月-2022年12月我院收治的58例中重度COPD患者为研究对象,根据随机数字表法将其分为研究组与对照组。研究组(n=29)采用常规干预联合肢体运动训练,对照组(n=29)采用常规干预。结果:干预前,2组肺功能、生活质量、呼吸困难程度、运动耐力以及血气指标比较,组间差异无统计学意义(P>0.05);干预后,研究组患者用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、FEV1/FVC均大于对照组,最大呼气中段平均流量多于对照组,日常生活活动能力、社会活动能力及抑郁症状、焦虑症状评分均低于对照组,呼吸困难程度评分低于对照组,6分钟步行距离长于对照组,动脉血氧分压、血氧饱和度高于对照组,动脉二氧化碳分压低于对照组,组间差异有统计学意义(P<0.05)。结论:老年中重度COPD患者实施肢体运动训练,不仅仅可以更好改善患者的肺功能和生活质量,同时也提高了患者的运动耐力,促进了患者各项血气指标的恢复。

噻托溴铵联合舒利迭对老年中重度COPD患者的疗效及生存质量研究

目的研究观察噻托溴铵联合舒利迭治疗老年中重度慢性阻塞性肺疾病（chronic obstructive pulmonary disease,COPD）的临床疗效及对患者生存质量的影响。方法选取广东省第二人民医院呼吸内科2014年1月~2016年1月收治的中重度COPD稳定期患者114例,按随机数字表法分为观察组和对照组,每组57例。对照组患者给予舒利迭治疗,观察组患者采用噻托溴铵联合舒利迭治疗,对比2组患者治疗效果和生活质量。结果治疗前,2组患者各项肺功能指标、MRC评分、6MWT及WHOQOL-100各项评分比较差异均无统计学意义;治疗后观察组患者FEV1/FVC、FEV1%显著于对照组,差异具有统计学意义（P〈0.05）;观察组患者呼吸困难程度评分（MRC）及6分钟步行试验（6MWT）明显优于对照组,差异具有统计学意义（P〈0.05）;观察组患者各项生存质量评分（WHOQOL-100）显著高于对照组,数据比较差异具有统计学意义（P〈0.05）。结论噻托溴铵联合舒利迭治疗老年中重度COPD疗效确切,可有效改善患者肺功能水平,提高患者生存质量。

APACHEⅡ对重症肺结核并COPD机械通气患者预后评估的价值

目的研究应用急性病理生理学和长期健康评价(APACHEⅡ)评估重症结核合并慢性阻塞性肺病(COPD)机械通气患者预后的价值。方法回顾分析2009年1月～2011年12月收住本院ICU的189例重症肺结核合并COPD机械通气患者临床资料,研究患者收入ICU 24 h内的APACHEⅡ评分结果与预后的关系。结果共纳入189例患者,其APACHEⅡ评分为平均18.8分;随着APACHEⅡ评分增高,患者实际病死率及预计病死率逐渐增高。结论 APACHEⅡ评分可用于重症肺结核合并COPD机械通气患者预后评估,对临床治疗具有指导意义。

舒利迭辅助治疗稳定期中重度COPD患者疗效观察

目的探讨舒利迭辅助治疗稳定期中重度慢性阻塞性肺疾病(COPD)的临床疗效。方法选择64例稳定期中重度COPD患者,按入院先后顺序随机分为观察组和对照组,每组32例。两组均给予常规治疗,观察组在常规治疗的基础上再给予舒利迭吸入,每次1喷,2次/d;对照组给予口服舒服美(缓释茶碱)片0.2g,2次/d,疗程均为8周,8周后比较两组的临床疗效。结果治疗后观察组的肺功能、血气指标及临床症状评分改善情况均明显优于对照组,组间差异具有显著性(P<0.05)。结论舒利迭辅助治疗稳定期中重度COPD,能显著改善患者的肺功能及临床症状,使用安全,可在临床上推广应用。