CAJ | 학술논문

目的：：探讨深吸气量( IC)与慢性阻塞性肺疾病急性加重期( AECOPD)患者Borg呼吸困难评分、住院时间、住院费用的相关性,为其疗效评估提供依据。方法：84例AECOPD患者中ΔIC改善率≥12％或增加≥200 ml作为对照Ⅰ组,ΔIC改善率<12％或增加<200 ml作为观察组,其中继续维持原方案治疗为对照Ⅱ组,加用吸入噻托溴胺粉雾剂18μg/d为对照Ⅲ组；在入院第1、3天及出院前进行肺通气功能和肺容量检查、Borg评分、血气分析测定,计算住院时间、住院费用。结果：3组患者入院第3天和出院前IC均高于入院第1天(P<0.05~P<0.01),且IC在对照Ⅰ组出院前明显高于入院第3天(P<0.01)。3组患者的ΔBorg评分、Δ第1秒用力呼气容积(FEV1)、IC/肺总量(TLC)和对照Ⅰ组与Ⅲ组ΔFEV1/用力肺活量(FVC)变化差异均有统计学意义(P<0.05~P<0.01),Ⅲ组患者出院前ΔPaCO2低于入院第3天(P<0.05),Ⅱ组患者ΔFEV1/FVC和3组功能残气量(FRC)、PaO2、对照Ⅰ组与Ⅱ组PaCO2变化差异均无统计学意义(P>0.05)；且Ⅰ组住院时间为7 d,住院费用6800元,Ⅱ组住院时间为11 d,住院费用10600元,Ⅲ组住院时间为9 d,住院费用8700元。3组患者在入院第3天、出院前的ΔIC与ΔBorg评分呈负相关关系(P<0.05),而ΔIC/TLC、ΔFEV1均与ΔBorg评分无相关关系(P>0.05)。3组患者在入院第3天、出院前的ΔIC与住院时间、住院费用均呈负相关关系(P<0.01)；而ΔFRC、ΔPaO2与住院时间均呈负相关关系(P<0.05),ΔPaCO2与住院时间呈正相关关系(P<0.05)；ΔIC/TLC与住院费用呈负相关关系(P<0.01),ΔPaO2、ΔPaCO2与住院费用均呈正相关关系(P<0.01),ΔFEV1、ΔFEV1/ FVC与其均无相关关系(P>0.05)。结论：应用IC对AECOPD患者治疗前后的病情评估,有助于制定治疗方案与疗效判定。
목적：：탐토심흡기량( IC)여만성조새성폐질병급성가중기( AECOPD)환자Borg호흡곤난평분、주원시간、주원비용적상관성,위기료효평고제공의거。방법：84례AECOPD환자중ΔIC개선솔≥12％혹증가≥200 ml작위대조Ⅰ조,ΔIC개선솔<12％혹증가<200 ml작위관찰조,기중계속유지원방안치료위대조Ⅱ조,가용흡입새탁추알분무제18μg/d위대조Ⅲ조；재입원제1、3천급출원전진행폐통기공능화폐용량검사、Borg평분、혈기분석측정,계산주원시간、주원비용。결과：3조환자입원제3천화출원전IC균고우입원제1천(P<0.05~P<0.01),차IC재대조Ⅰ조출원전명현고우입원제3천(P<0.01)。3조환자적ΔBorg평분、Δ제1초용력호기용적(FEV1)、IC/폐총량(TLC)화대조Ⅰ조여Ⅲ조ΔFEV1/용력폐활량(FVC)변화차이균유통계학의의(P<0.05~P<0.01),Ⅲ조환자출원전ΔPaCO2저우입원제3천(P<0.05),Ⅱ조환자ΔFEV1/FVC화3조공능잔기량(FRC)、PaO2、대조Ⅰ조여Ⅱ조PaCO2변화차이균무통계학의의(P>0.05)；차Ⅰ조주원시간위7 d,주원비용6800원,Ⅱ조주원시간위11 d,주원비용10600원,Ⅲ조주원시간위9 d,주원비용8700원。3조환자재입원제3천、출원전적ΔIC여ΔBorg평분정부상관관계(P<0.05),이ΔIC/TLC、ΔFEV1균여ΔBorg평분무상관관계(P>0.05)。3조환자재입원제3천、출원전적ΔIC여주원시간、주원비용균정부상관관계(P<0.01)；이ΔFRC、ΔPaO2여주원시간균정부상관관계(P<0.05),ΔPaCO2여주원시간정정상관관계(P<0.05)；ΔIC/TLC여주원비용정부상관관계(P<0.01),ΔPaO2、ΔPaCO2여주원비용균정정상관관계(P<0.01),ΔFEV1、ΔFEV1/ FVC여기균무상관관계(P>0.05)。결론：응용IC대AECOPD환자치료전후적병정평고,유조우제정치료방안여료효판정。
Objective:To investigate the relationship between the inspiratory capacity(IC) and Borg score,hospitalization time and cost in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD),and provide the basis in evaluating the clinical effects. Methods:The 84 AECOPD patients with improvement rate ≥12% or increasing 200 ml of ΔIC, and <12% or increasing <200 ml were divided into the control Ⅰ group and observation group. The patients treated with continual treatment using the original scheme or combined with 18 μg/d of tiotropium were divided into the control Ⅱ group and Ⅲ group, respectively. The pulmonary ventilation function and lung capacity, Borg score, blood gas analysis, hospitalization time and cost in all patents were analyzed after 1 and 3 d of admission and before discharge. Results:After 3 d of admission and before discharge,IC in 3 groups were than that in the first day after adnission(P<0. 05 to P<0. 01),and the IC in Ⅰ group was significantly higher than that in the third day after admission(P<0. 01). The differences of the Borg score,FEV1 and IC/TLC in 3 groups,and the difference of the ΔFEV1/FVC between Ⅰ and Ⅲ group were statistically significant(P<0. 05 to P<0. 01). The ΔPaCO2 in Ⅲ group before discharge was lower than that in the third day after admission(P<0. 05). The differences of theΔFEV1/FVC inⅡgroup,FRC and PaO2 in 3 groups and the PaCO2 betweenⅠandⅡgroup were not statistical significance(P>0. 05). The hospitalization time and cost inⅠ,ⅡandⅢgroup were 7 d & 6 800 yuan,11 d & 10 600 yuan and 9 d & 8 700 yuan,respectively. Among the 3 groups in the third day of admission and before discharge,the Δ IC in 3 groups were negatively correlated with theΔBorg score. hospitalization time and cost( P<0. 05),and theΔIC/TLC andΔFEV1 were not correlated with theΔBorg score(P>0. 05). Among the 3 groups in the third day of admission and before discharge,the ΔFRC and ΔPaO2 were negatively correlated with the hospitalization time(P<0.05),and theΔPaCO2 were positively correlated with the hospitalization cost(P < 0. 05),the ΔIC/TLC was negatively correlated with the hospitalization cost(P<0. 01),the ΔPaO2 and ΔPaCO2 were positively correlated with the hospitalization cost(P<0. 01),and the formulate the treatment plan.