CAJ | 학술논문

目的：探讨改良诱导痰技术在中重度、极重度慢性阻塞性肺疾病急性加重期（AECOPD）的安全性。方法：收集住院的90例中重度、极重度 AECOPD 患者，其中合并Ⅰ、Ⅱ型呼吸衰竭27例，合并冠心病18例，合并心动过速38例，给予改良诱导痰，诱导过程中给予心电监护并每间隔5 min 行床边肺功能检查，记录FEV1、HR、SpO2。结果：90例患者共进行了224次诱导痰，其中222次安全完成诱导痰过程，取得合格痰标本216次，诱导痰成功率为96．43％；诱导痰过程中 HR 上升、SpO2下降主要发生在诱导痰开始的5 min，FEV1在整个诱导过程无变化。结论：Ⅰ、Ⅱ型呼吸衰竭的中重度、极重度 AECOPD 患者在密切监测下通过改良的诱导痰技术进行诱导痰是比较安全的，但患者若同时合并有冠心病及快速型心率失常，进行诱导痰的风险将稍有增加，特别是在诱导痰开始的5 min 内。
목적：탐토개량유도담기술재중중도、겁중도만성조새성폐질병급성가중기（AECOPD）적안전성。방법：수집주원적90례중중도、겁중도 AECOPD 환자，기중합병Ⅰ、Ⅱ형호흡쇠갈27례，합병관심병18례，합병심동과속38례，급여개량유도담，유도과정중급여심전감호병매간격5 min 행상변폐공능검사，기록FEV1、HR、SpO2。결과：90례환자공진행료224차유도담，기중222차안전완성유도담과정，취득합격담표본216차，유도담성공솔위96．43％；유도담과정중 HR 상승、SpO2하강주요발생재유도담개시적5 min，FEV1재정개유도과정무변화。결론：Ⅰ、Ⅱ형호흡쇠갈적중중도、겁중도 AECOPD 환자재밀절감측하통과개량적유도담기술진행유도담시비교안전적，단환자약동시합병유관심병급쾌속형심솔실상，진행유도담적풍험장초유증가，특별시재유도담개시적5 min 내。
Objective To evaluate the safety of modified sputum induction in moderate to very severe COPD during exacerbation. Methods Ninety patients with moderate, severe or very severe COPD during exacerbation (27 with type Ⅰ and Ⅱ respiratory failure,18 with coronary heart disease, 38 with tachycardia) were chosen as research subjects. All the patients underwent induced sputum. During induction , all patients were given electrocardiographic monitoring and pulmonary function check every 5 minutes and FEV1, HR, SpO2 in the process of testing were recorded. Results Ninety patients underwent 224 sputum inductions progress, 222 were safety. Qualified sputum samples were collected for 216 times, sputum induction was successful in 96.43% of occasions. Heart rate rising and SpO2 reducing during sputum induction mainly occurred in the beginning 5 minutes, FEV1 did not change in the whole process. Conclusion Modified sputum induction can be safe through closely monitoring in patients with moderate-to-very severe COPD with exacerbation, even with type Ⅰ or typeⅡ respiratory failure. But the risk of sputum induction will increase if patients with coronary heart disease and tachyarrhythmia, especially within beginning 5 minutes of sputum induction.