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中应用的安全性分析  

Safety of modified sputum induction in moderate-to-very severe COPD during exacerbation

作　　者：魏立平[1] 康闪闪[1] 何晟[1] 林敏[1] 朱恬华[1] 梁伟强[1] 李芳[1] 

机构地区：[1]广州医科大学附属第三医院呼吸内科,510150

出　　处：《实用医学杂志》2014年第17期2751-2753,共3页The Journal of Practical Medicine

基　　金：广东省自然科学基金资助项目(编号:9151170003000005)

摘　　要：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。Objective To evaluate the safety of modified sputum induction in moderate to very severeCOPD 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 chosenas research subjects. All the patients underwent induced sputum. During induction, all patients were givenelectrocardiographic monitoring and pulmonary function check every 5 minutes and FEV,, HR, SpO2 in the processof 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 SpOz reducing during sputum induction mainly occurred in the beginning 5 minutes, FEV1 didnot change in the whole process. Conclusion Modified sputum induction can be safe through closely monitoring inpatients with moderate-to-very severe COPD with exacerbation, even with type I or type II respiratory failure. Butthe risk of sputum induction will increase if patients with coronary heart disease and tachyarrhythmia, especiallywithin beginning 5 minutes of sputum induction.

关 键 词：肺疾病 慢性阻塞性 诱导痰 急性加重期 安全性 呼吸衰竭 

分 类 号：R563.9[医药卫生—呼吸系统]