慢性阻塞性肺疾病急性加重期氧气射流驱动雾化治疗的安全性研究  

Safety of Oxygen-driven Nebulization on Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

作　　者：张义宏 王永滨 周静 沈景昊 李晓凤 顾明芳 吴万里 ZHANG Yi-hong;WAMG Yong-bin;ZHOU Jing;SHEN Jing-hao;LI Xiao-feng;GU Ming-fang;WU Wan-li(Department of Respiration,SuzhouXiangcheng People’s Hospital,Jiangsu,Suzhou,215131,China)

机构地区：[1]苏州市相城人民医院/复旦大学附属中山医院长三角合作医院,江苏苏州215131 [2]贵州省石阡县中医院,贵州石阡555100

出　　处：《中国初级卫生保健》2022年第10期110-113,共4页Chinese Primary Health Care

基　　金：苏州市科技项目(sysd2017055)。

摘　　要：目的:探讨使用氧气射流驱动雾化疗法治疗慢性阻塞性肺疾病(简称慢阻肺)急性加重期的安全性。方法:选取2017年8月—2019年11月苏州市相城人民医院收治的92例慢阻肺急性加重期住院患者为研究对象,将其随机分为两组,每组各46例,分别采用氧气射流驱动雾化治疗(ODN组)和压缩空气驱动雾化治疗(ADN组),吸入药物均使用沙丁胺醇+布地奈德。对比两组患者雾化吸入治疗前后血气分析相关指标变化以及神志、心率、呼吸频率、耐受性情况,并利用经皮二氧化碳分压(PCO)测定仪检测患者从雾化开始到结束后18 min内PCO的变化情况。结果:雾化治疗后,ODN组患者PO显著升高,差异有统计学意义(t=5.60,P<0.05);治疗过程中,ODN组出现呼吸困难患者4例,而ADN组出现呼吸困难患者18例,两组比较,差异有统计学意义(χ^(2)=10.99,P<0.05)。经皮PCO分压持续监测结果显示,受试者PCO在雾化后2~6 min时有轻度升高,最高可上升5 mmHg(1 mmHg=1.333 kPa),但很快出现下降,在雾化结束后12 min,PCO基本恢复到基线水平。结论:短时间内使用氧气射流驱动雾化疗法对慢阻肺急性加重患者进行治疗是安全的。OBJECTIVE To investigate the safety of oxygen-driven jet nebulization therapy during acute exacerbation of chronic obstructive pulmonary disease.METHODS A total of 92 inpatients with acute exacerbation of COPD were randomly divided into two groups(n=46),and they were treated with oxygen-driven nebulization therapy(ODN group)and compressed air-driven nebulization therapy(ADN group)(inhaled drugs used albuterol+budesonide)respectively.The changes of blood gas analysis indexes,consciousness,heart rate,respiratory rate,and tolerance of the two groups of patients before and after nebulization inhalation were compared,and the carbon dioxide concentration within 18 minutes from the beginning to the end of nebulization was detected by transcutaneous carbon dioxide partial pressure analyzer.RESULTS After atomization treatment,POin ODN group increased,the difference was statistically significant(t=5.60,P<0.05).During treatment,4 patients appeared in ODN group and 18 patients in ADN group,compared with the two groups(χ^(2)=10.99,P<0.05).The continuous monitoring of percutaneous carbon dioxide partial pressure showed that the subject PCOwas slightly increased from 2 to 6 min after aerosolization,up to 5 mmHg(1 mmHg=1.333 kPa),but soon decreased,and PCObasically returned to baseline at 12 min after aerosolization.CONCLUSION Short-term oxygen-driven nebulization therapy is safe in patients with acute exacerbations of chronic obstructive pulmonary disease.

关 键 词：慢性阻塞性肺疾病 急性加重期 氧气驱动雾化 压缩空气驱动雾化 治疗 安全性 

分 类 号：R563.9[医药卫生—呼吸系统]