雾化吸入沙丁胺醇联合无创机械通气治疗慢性阻塞性肺疾病急性发作的临床分析  

Clinical analysis of aerosol inhalation of salbutamol combined with non-invasive mechanical ventilation for treating acute exacerbation of chronic obstructive pulmonary disease

作　　者：杨青 胡英杰[2] Yang Qing;Hu Yingjie(Department of Respiratory and Critical Care Medicine, People′s Hospital of Ningguo City, Ningguo 242300, China;Clinical Center for Lung Cancer, Shanghai Chest Hospital, Shanghai 200030, China)

机构地区：[1]安徽省宁国市人民医院呼吸与危重症学科,宁国242300 [2]上海市胸科医院肺部肿瘤临床中心,上海200030

出　　处：《中华肺部疾病杂志（电子版）》2020年第4期475-478,共4页Chinese Journal of Lung Diseases(Electronic Edition)

基　　金：青年科学基金项目(1608085QH210)。

摘　　要：目的探讨雾化吸入沙丁胺醇联合无创机械通气治疗方案对慢性阻塞性肺疾病急性发作(AECOPD)患者支气管舒张反应、气体交换参数的影响。方法选取我院80例(AECOPD)患者,随机分为2组,对照组38例,实验组42例,对照组采用无创机械通气疗法,实验组于其基础上雾化吸入沙丁胺醇,比较2组治疗前后肺功能[用力肺活量(FVC)、1 s用力呼气量(FEV1)、FEV1/FVC]、气体交换参数[每分钟通气量(VE)、潮气量(VT)、呼吸频率(RR)]、支气管舒张试验反应[FVC改变量(ΔFVC)与改善率、FEV1改变量(ΔFEV1)与改善率]、症状与体征消失时间及不良反应情况。结果实验组治疗后FVC、FEV1、FEV1/FVC显著高于对照组(P<0.05);实验组治疗后VE、VT、RR显著高于对照组(P<0.05);2组ΔFEV1与改善率比较无显著差异(P>0.05),实验组ΔFVC与改善率明显小于对照组(P<0.05);实验组咳嗽、喘憋、发绀、肺啰音消失时间明显短于对照组(P<0.05);2组不良反应总发生率比较无显著差异(P>0.05)。结论雾化吸入沙丁胺醇联合无创机械通气可有效改善AECOPD患者肺功能与气体交换参数,降低支气管舒张试验反应,促进症状与体征恢复,且安全性高。Objective To observe the effect of aerosol inhalation of salbutamol combined with non-invasive mechanical ventilation on the bronchodilation response and gas exchange parameters in the patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods Eighty patients with AECOPD were selected from our hospital and randomized into two groups with the number table method,with 40 cases in each group.The control group was treated with non-invasive mechanical ventilation,and the experimental group was treated with aerosol inhalation of salbutamol combined with non-invasive mechanical ventilation.The lung function parameters[the forced vital capacity(FVC),the forced expiratory volume in one second(FEV1),and FEV1/FVC],the gas exchange parameters[the minute ventilation volume(VE),the tidal volume(VT),and the respiratory rate(RR)],the bronchial dilation test response[the change in FVC(ΔFVC)and its improvement rate,and the change in FEV1(ΔFEV1)and its improvement rate],the disappearance time of the symptoms and signs,and the adverse reactions were compared between the two groups.Results After treatment,the FVC,FEV1,FEV1/FVC,VE,VT and RR in the experimental group were significantly higher than those of the control group(P<0.05).There was no significant difference in theΔFEV1 or its improvement rate between the two groups(P>0.05).TheΔFVC and its improvement rate in the experimental group were significantly lower than those of the control group(P<0.05).The disappearance time of cough,dyspnea,cyanosis and lung rales in the experimental group was significantly shorter than that of the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Aerosol inhalation of salbutamol combined with non-invasive mechanical ventilation can effectively improve the lung function and gas exchange parameters in the patients with AECOPD,reduce the bronchodilation response,promote the recovery of the symptoms and signs,and has a high s

关 键 词：沙丁胺醇 无创机械通气 肺疾病 慢性阻塞性 支气管舒张反应 气体交换参数 

分 类 号：R563[医药卫生—呼吸系统]