中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2011年
4期
459-461
,共3页
布地奈德%慢性阻塞性肺疾病%呼吸机相关性肺炎%机械通气
佈地奈德%慢性阻塞性肺疾病%呼吸機相關性肺炎%機械通氣
포지내덕%만성조새성폐질병%호흡궤상관성폐염%궤계통기
Budesonide%Chronic obstructive pulmonary disease%Ventilator-associated pneumonia%Mechanical ventilation
目的 探讨雾化吸入布地奈德对慢性阻塞性肺疾病(COPD)合并呼吸机相关性肺炎(VAP)的影响.方法 49例COPD合并VAP患者,随机分成两组:对照组24例,应用复方异丙托溴铵雾化吸入合用广谱抗菌素;观察组25例,在对照组治疗基础上雾化器中加入布地奈德混悬液,与复方异丙托溴铵同时雾化.观察两组患者的疗效和上机72 h后支气管肺泡灌洗液(BALF)中肿瘤坏死因α(TNF-α)、白细胞介素8(IL-8)的变化.结果 观察组患者上机72 h后BALF中TNF-α和IL-8水平较对照组均明显降低(均P＜0.05).观察组患者症状和体征,以及床旁胸片改善时间、脱机时间、拔管时间、出院时间均优于对照组(均P＜0.05).观察组临床治愈率未改善.结论 雾化吸入糖皮质激素可减轻气道炎性反应,可缩短COPD合并VAP患者的上机时间,改善预后.
目的 探討霧化吸入佈地奈德對慢性阻塞性肺疾病(COPD)閤併呼吸機相關性肺炎(VAP)的影響.方法 49例COPD閤併VAP患者,隨機分成兩組:對照組24例,應用複方異丙託溴銨霧化吸入閤用廣譜抗菌素;觀察組25例,在對照組治療基礎上霧化器中加入佈地奈德混懸液,與複方異丙託溴銨同時霧化.觀察兩組患者的療效和上機72 h後支氣管肺泡灌洗液(BALF)中腫瘤壞死因α(TNF-α)、白細胞介素8(IL-8)的變化.結果 觀察組患者上機72 h後BALF中TNF-α和IL-8水平較對照組均明顯降低(均P＜0.05).觀察組患者癥狀和體徵,以及床徬胸片改善時間、脫機時間、拔管時間、齣院時間均優于對照組(均P＜0.05).觀察組臨床治愈率未改善.結論 霧化吸入糖皮質激素可減輕氣道炎性反應,可縮短COPD閤併VAP患者的上機時間,改善預後.
목적 탐토무화흡입포지내덕대만성조새성폐질병(COPD)합병호흡궤상관성폐염(VAP)적영향.방법 49례COPD합병VAP환자,수궤분성량조:대조조24례,응용복방이병탁추안무화흡입합용엄보항균소;관찰조25례,재대조조치료기출상무화기중가입포지내덕혼현액,여복방이병탁추안동시무화.관찰량조환자적료효화상궤72 h후지기관폐포관세액(BALF)중종류배사인α(TNF-α)、백세포개소8(IL-8)적변화.결과 관찰조환자상궤72 h후BALF중TNF-α화IL-8수평교대조조균명현강저(균P＜0.05).관찰조환자증상화체정,이급상방흉편개선시간、탈궤시간、발관시간、출원시간균우우대조조(균P＜0.05).관찰조림상치유솔미개선.결론 무화흡입당피질격소가감경기도염성반응,가축단COPD합병VAP환자적상궤시간,개선예후.
Objective To explore the effect of budesonide nebulization in treatment of patients with chronic obstructive pulmonary disease and ventilator-associated pneumonia. Methods A total of 49 cases with COPD and VAP was randomly divided into two groups:the control group consisted of 24 patients received salbutamol nebulization on the routine treatment.The observe group consisted of 25 patients received budesonide plus salbutamol bulization on the routine treatment.Variables such as TNF-αt and IL-8 in the bronchial alveolar lavage fluid(BALF),and efficacy of pneumonia and clinical healing rate were observed. Results The levels of TNF-α and IL-8 in BALF of the observe group were significantly lower than those in the control group after 72h(all P＜0.05).The days of symptoms,signs and bedside chest X-ray improved,off-machine time,extubation time and the days of inpatient were statistically shorter in observe group compared with the control group(all P＜0.05).But the clinical cure rate of the observe group was no significant improvement. Conclusion The nebulization of budesonide could suppress the local pulmonary inflammation and reduce the time of machine ventilation and improve prognosis in COPD patients with VAP.
