临床肺科杂志
臨床肺科雜誌
림상폐과잡지
JOUNAL OF CLINICAL PULMONARY MEDICINE
2014年
10期
1800-1803
,共4页
双水平气道正压通气%雾化吸入%支气管扩张剂%复方异丙托溴铵%沙丁胺醇%异丙托溴铵%慢性阻塞性肺疾病
雙水平氣道正壓通氣%霧化吸入%支氣管擴張劑%複方異丙託溴銨%沙丁胺醇%異丙託溴銨%慢性阻塞性肺疾病
쌍수평기도정압통기%무화흡입%지기관확장제%복방이병탁추안%사정알순%이병탁추안%만성조새성폐질병
bi-level positive airway pressure ventilation%atomization inhalation%bronchodilators%compound ipratropium bromide%salbutamol%ipratropium bromide%chronic obstructive pulmonary disease
目的：探讨双水平气道正压通气( BiPAP)呼吸机加雾化吸入复方异丙托溴铵溶液治疗慢性阻塞性肺疾病急性加重( AECOPD)的临床疗效。方法96例AECOPD 患者随机分为治疗组和对照组。两组患者均根据痰培养及药敏结果选用敏感抗生素,纠正酸碱失衡及水、电解质紊乱,给予解痉平喘、止咳祛痰及营养支持等常规治疗,并使用BiPAP呼吸机治疗。治疗组在此基础上加用复方异丙托溴铵溶液2 ml(含异丙托溴铵4 mg,沙丁胺醇2 mg)加生理盐水3 ml雾化吸入15~20 min,2次/d。结果①治疗组总有效率为91.7%(44/48),对照组总有效率为81.3%(39/48),两组比较差异有统计学意义(P<0.05)；②治疗组死亡1例,对照组死亡3例,两组对比差异无统计学意义(P>0.05)。③治疗后两组动脉血二氧化碳分压逐渐下降,治疗组下降更明显,两组比较差异均有统计学意义(P<0.01)。治疗后两组动脉血氧分压、pH、动脉血氧饱和度逐渐升高,治疗组升高更明显,两组比较差异均有统计学意义( P<0.05或P<0.01)。④治疗后两组心率、呼吸频率逐渐下降,治疗组下降更明显,两组比较差异均有统计学意义( P<0.05或P<0.01)。⑤治疗组与对照组通气时间、住院天数比较差异有统计学意义(P<0.01),治疗组通气时间、住院天数均比对照组缩短。结论 BiPAP联合雾化吸入复方异丙托溴铵溶液治疗AECOPD具有疗效显著、操作简单、安全方便等优点,值得在临床推广应用。
目的：探討雙水平氣道正壓通氣( BiPAP)呼吸機加霧化吸入複方異丙託溴銨溶液治療慢性阻塞性肺疾病急性加重( AECOPD)的臨床療效。方法96例AECOPD 患者隨機分為治療組和對照組。兩組患者均根據痰培養及藥敏結果選用敏感抗生素,糾正痠堿失衡及水、電解質紊亂,給予解痙平喘、止咳祛痰及營養支持等常規治療,併使用BiPAP呼吸機治療。治療組在此基礎上加用複方異丙託溴銨溶液2 ml(含異丙託溴銨4 mg,沙丁胺醇2 mg)加生理鹽水3 ml霧化吸入15~20 min,2次/d。結果①治療組總有效率為91.7%(44/48),對照組總有效率為81.3%(39/48),兩組比較差異有統計學意義(P<0.05)；②治療組死亡1例,對照組死亡3例,兩組對比差異無統計學意義(P>0.05)。③治療後兩組動脈血二氧化碳分壓逐漸下降,治療組下降更明顯,兩組比較差異均有統計學意義(P<0.01)。治療後兩組動脈血氧分壓、pH、動脈血氧飽和度逐漸升高,治療組升高更明顯,兩組比較差異均有統計學意義( P<0.05或P<0.01)。④治療後兩組心率、呼吸頻率逐漸下降,治療組下降更明顯,兩組比較差異均有統計學意義( P<0.05或P<0.01)。⑤治療組與對照組通氣時間、住院天數比較差異有統計學意義(P<0.01),治療組通氣時間、住院天數均比對照組縮短。結論 BiPAP聯閤霧化吸入複方異丙託溴銨溶液治療AECOPD具有療效顯著、操作簡單、安全方便等優點,值得在臨床推廣應用。
목적：탐토쌍수평기도정압통기( BiPAP)호흡궤가무화흡입복방이병탁추안용액치료만성조새성폐질병급성가중( AECOPD)적림상료효。방법96례AECOPD 환자수궤분위치료조화대조조。량조환자균근거담배양급약민결과선용민감항생소,규정산감실형급수、전해질문란,급여해경평천、지해거담급영양지지등상규치료,병사용BiPAP호흡궤치료。치료조재차기출상가용복방이병탁추안용액2 ml(함이병탁추안4 mg,사정알순2 mg)가생리염수3 ml무화흡입15~20 min,2차/d。결과①치료조총유효솔위91.7%(44/48),대조조총유효솔위81.3%(39/48),량조비교차이유통계학의의(P<0.05)；②치료조사망1례,대조조사망3례,량조대비차이무통계학의의(P>0.05)。③치료후량조동맥혈이양화탄분압축점하강,치료조하강경명현,량조비교차이균유통계학의의(P<0.01)。치료후량조동맥혈양분압、pH、동맥혈양포화도축점승고,치료조승고경명현,량조비교차이균유통계학의의( P<0.05혹P<0.01)。④치료후량조심솔、호흡빈솔축점하강,치료조하강경명현,량조비교차이균유통계학의의( P<0.05혹P<0.01)。⑤치료조여대조조통기시간、주원천수비교차이유통계학의의(P<0.01),치료조통기시간、주원천수균비대조조축단。결론 BiPAP연합무화흡입복방이병탁추안용액치료AECOPD구유료효현저、조작간단、안전방편등우점,치득재림상추엄응용。
Objective To study the clinical efficacy of bi-level positive airway pressure ventilation ( BiPAP) ventilator combined with nebulized ipratropium bromide in the treatment of AECOPD. Methods 96 AECOPD pa-tients were randomly divided into the treatment group and the control group. All patients were given related antibiotics based on the results of drug sensitivity test, correction of acid-base imbalance and water, electrolyte disturbance, an-tispasmodic, cough expectorant and nutritional support, and BiPAP ventilator therapy. The treatment group was addi-tionally treated with compound ipratropium bromide solution (ipratropium bromide 4 mg, salbutamol 2mg ) for 2 ml plus saline aerosol inhalation of 3 ml 15 to 20 min, twice a day. Results ① The total effective rate was 91. 7%(44/48) in the treatment group and 81. 3% (39/48) in the control group (P<0. 05). ②There was 1 case of death reported in the treatment group and 3 cases in the control group (P>0. 05). ③After the treatment, the decrease of arterial partial pressure of carbon dioxide was more obviously in the treatment than in the control group (P<0. 01). The increase of pH and arterial oxygen partial pressure of arterial oxygen saturation was more pronounced in the treat-ment group than in the control group. ④The heart rate and respiratory rate decreased gradually after the treatment in the two groups, and the decrease was more pronounced in the treatment group than in the control group ( P<0. 05 or P<0. 01). ⑤ There were significant differences in ventilation time and duration of hospital stay between the two groups (P<0. 01). Conclusion BiPAP combined with nebulized ipratropium bromide solution has obvious curative effect with the advantages of simple operation and high safety in the treatment of AECOPD.
