两种不同吸入方法治疗慢性阻塞性肺疾病合并呼吸衰竭效果的研究被引量：40

Clinical study on treatment of two different aerosol inhalations for AECOPD complicated with respiratory failure

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摘要目的探讨两种不同吸入方法治疗慢阻肺合并呼吸衰竭的临床疗效。方法将66例慢阻肺疾病急性加重合并呼吸衰竭患者随机分为研究组和对照组,各33例。研究组采用无创正压通气同时联合雾化吸入布地奈德治疗;对照组采用中心管道氧气雾化吸入布地奈德治疗,采用SPSS 19软件分析。结果研究组与对照组入院时的情况基本相同(P>0.05);研究组治疗方法降低患者Pa CO_2效果较对照组更明显,差异有统计学意义(t=4.55 P=0.03);同样升高患者Pa O_2效果较对照组更明显,差异有统计学意义(t=4.70P=0.03);研究组治疗方法缓解患者呼吸困难效果较对照组更明显,差异有统计学意义(t=4.32 P=0.04);m MRC变化研究组治疗方法较对照组改善更明显,差异有统计学意义(t=2.55 P=0.01);CCQ变化研究组治疗方法较对照组改善更明显,差异有统计学意义(t=3.13 P=0.00)。结论无创正压通气同时联合雾化吸入布地奈德治疗方法与中心管道氧气雾化吸入布地奈德方法治疗慢阻肺急性加重期合并呼吸衰竭相比,可更有效的纠正缺氧、缓解患者呼吸困难,也可有效降低CO_2潴留。 Objective To explore the curative effect of two different aerosol inhalations for AECOPD patients complicated with respiratory failure .Methods 66 AECOPD patients complicated with respiratory failure were ran-domly divided into the study group and the control group （33 patients for each group）.For the study group, aerosol inhalation of budesonide treatment was simultaneously combined with noninvasive positive pressure ventilation .For the control group , noninvasive positive pressure ventilation was temporarily stopped during the aerosol inhalation of budesonide .All outcomes were statistically analyzed using SPSS 19 software package .Results There was no signifi-cant difference in basic situation between the two groups before treatment （ P〉0.05 ） .The decrease of PCO 2 after treatment was more obvious in the study group than in the control group （t=4.55, P=0.03）, and the increase of PO2 after treatment as more obvious in the study group than in the control group （t=4.70, P=0.03）.The remission of tachypnea in the study group was more significant than that in the control group （t=4.32, P=0.043）.The im-provement of mMRC in the study group was more significant than that in the control group （t=2.55, P=0.014）, and the improvement of CCQ in the study group was more significant than that in the control group （ t=3.13, P=0.003）.Conclusion While comparing with noninvasive positive pressure ventilation temporarily stopped , there are much more significant improvements and remissions of CO 2 retention, anoxia, tachypnea, dyspnea （mMRC）, quality of life （CCQ）, and other clinical indexes （clinical rating, APACHE II） by aerosol inhalation of budesonide com-bined with noninvasive positive pressure ventilation simultaneously .

作者蒋明彦刘国平刘中华贺志文

机构地区湘潭市中心医院呼吸与危重症医学科

出处《临床肺科杂志》 2016年第9期1624-1627,共4页 Journal of Clinical Pulmonary Medicine

关键词慢性阻塞性肺疾病无创正压通气吸入治疗 chronic obstructive pulmonary disease noninvasive positive pressure ventilation aerosol inhalation

分类号 R563.9 [医药卫生—呼吸系统] R563.8 [医药卫生—呼吸系统]

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1GOLD Executive Committee Global strategy for the diagnosis,management,andprevention of chronic obstructive pulmonary diseaseup dated 2013[EB/OL]http://www.gold COPD.org/Guidelines/guidelines-resources.html,2013.
2Daldoul H,Denguezli M,Jithoo A,et al.Prevalence of COPD and Tobacco Smoking in Tunisia-Results from the BOLD Study[J].Intern J Enviro Resear Pub Health,2013,10(12):7257-7271.
3Fang X,Wang X,Bai C.COPD in China:the burden and importance of proper management[J].Chest,2011,139(4):920-929.
4Zachariades A G,Zachariadou T,Adamide T,et al.Prevalence of chronic obstructive pulmonary disease in Cyprus:A populationbased study[J].COPD:J Chro Obstr Pulm Dis,2012,9(3):259-267.
5阙呈立.慢性阻塞性肺疾病的呼吸生理和临床应用[J].中国医学前沿杂志（电子版）,2012,4(1):3-5. 被引量：7
6Nava S,Karakurt S,Rampulla C,et al.Salbutamol delivery during non-invasive mechanical ventilation in patients with chronic obstructive pulmonary disease:a randomized,controlled study[J].Intensive Care Medi,2001,27(10):1627-1635.
7Galindo-Filho V C,Brand?o D C,Rita de Cássia S F,et al.Noninvasive Ventilation Coupled With Nebulization During Asthma Crises:A Randomized Controlled Trial[J].Respira Care,2013,58(2):241-249.
8Alcoforado L,Brand?o S,Rattes C,et al.Evaluation of lung function and deposition of aerosolized bronchodilators carried by heliox associated with positive expiratory pressure in stable asthmatics:A randomized clinical trial[J].Respir Med,2013.
9李思灵.无创通气联合雾化吸入布地奈德十复方异丙托溴铵在COPD并Ⅱ型呼吸衰竭患者中应用[J].齐齐哈尔医学院学报,2014,35(12):1763-1764. 被引量：5
10钟祥柱,黄响玲,黄海鹰,康萍,谢晋烈,赵东,黄河,唐琳,彭伟芬,马颖彤.无创通气联合雾化吸入支气管扩张剂在COPD并Ⅱ型呼吸衰竭患者中的应用[J].广东医学院学报,2007,25(1):26-28. 被引量：5

二级参考文献18

1张波,高和.无创通气在急性呼吸衰竭患者中的应用//张波,高和.实用机械通气治疗手册[M].北京:人民军医出版社,2002:177-179.
2MOULOUDI E,KATSANOULAS K,ANASTASAKI M.Bronchodilator delivery by metered-dose inhaler in mechanically ventilated COPD patients:influence of tidal volume[J].Intensive Care Med,1999,25(11):1215-1221.
3PARKES S N,BERSTEN A D.Aerosol kinetics and bronchodilator efficacy during continuous positive airway pressure delivered by face mas[J].Thorax,1997,52(2):171-175.
4CHATMONGKOLCHART S,SCHETTION G P,DILLMAN C.In vitro evaluation of aerosol bronchodilator delivery during noninvasive positive pressure ventilation:effect of ventilator settings and nebulizer position[J].Crit Care Med,2002:30(11):2515-2519.
5MOULOUDI E,PRINIANAKTIS G,KONDILI E.Bronchodilator delivery by metered-dose inhaler in mechanically ventilated COPD patients:influence of flow pattern[J].Eur Respir J,2000,16(2):263-268.
6.Global Initiative for Chronic Obstructive Lung Disease[].http//wwwgoldcopdorg.2011
7McDonough JE,Yuan R,Suzuki M,et al.Small-airway obstruction and emphysema in chronic obstructive pulmonary disease[].The New England Journal of Medicine.2011
8Fessler HE,Scharf SM,Ingenito EP,et al.Physiologic basis for improved pulmonary function after lung volume reduction[].Proc Am Thorac Soc.2008
9Gosselink R,De Vos J,Van den Heuvel SP,et al.Impact of inspiratory muscle training in patients with COPD:What is the evidence[].European Respiratory Journal.2011
10Berger RL,Decamp MM,Criner GJ,et al.Lung volume reduction therapies for advanced emphysema:an update[].Chest.2010