糖皮质激素、沙丁胺醇雾化吸入联合无创机械正压通气对COPD急性加重期患者血气指标及呼吸力学的影响  

Effect of Glucocorticoid and Salbutamol Atomization Inhalation Combined with Noninvasive Positive Pressure Ventilation on Blood Gas Index and Respiratory Mechanics in Patients with Acute Exacerbation of COPD

作　　者：汪晓琳 方蕾 危政 WANG Xiao-lin;FANG Lei;WEI Zheng(Department of General Internal Medicine,Yushan County Hospital of Traditional Chinese Medicine,Yushan 334000,Jiangxi,China;Department of General Internal Medicine,ICU,Yushan 334000,Jiangxi,China)

机构地区：[1]玉山县中医院普内科,江西玉山334000 [2]玉山县中医院ICU,江西玉山334000

出　　处：《医学信息》2022年第21期73-76,共4页Journal of Medical Information

摘　　要：目的评价给予急性加重期COPD患者沙丁醇胺、糖皮质激素联合无创正压通气治疗的效果及对患者呼吸力学指标和血气指标变化的影响。方法选取2020年7月-2021年7月我院收治的COPD急性加重期患者68例,采用随机数字表法分为联合治疗组与对照组,每组34例。对照组给予无创机械通气加布地奈德雾化吸入治疗,联合治疗组在对照组的基础上给予沙丁胺醇雾化吸入治疗,比较两组血气指标(动脉血二氧化碳分压、动脉血氧分压、氧合指数)、呼吸力学指标[第1秒呼气的最大容积(FEV1)占用力肺活量(FVC)百分比、FVC、FEV1]、炎症因子[白介素-10(IL-10)、白介素-8(IL-8)、白介素-6(IL-6)]、生化指标(C-反应蛋白、白蛋白与球蛋白比值)及不良反应发生率。结果联合治疗组氧合指数、动脉血氧分压高于对照组,动脉血二氧化碳分压低于对照组(P<0.05);联合治疗组FEV1/FVC%、FVC、FEV1高于对照组(P<0.05);联合治疗组IL-10、IL-8、IL-6低于对照组(P<0.05);联合治疗组C-反应蛋白低于对照组,白蛋白与球蛋白比值高于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论沙丁醇胺、糖皮质激素联合无创正压通气治疗急性加重期COPD患者效果良好,可促进患者呼吸力学指标、血气指标改善,降低炎性反应,且不增加不良反应,安全性较高。Objective To evaluate the effect of salbutamol and glucocorticoid combined with non-invasive positive pressure ventilation in patients with acute exacerbation of COPD and its effect on the changes of respiratory mechanics and blood gas indexes.Methods A total of 68 patients with acute exacerbation of COPD admitted to our hospital from July 2020 to 2021 were selected and divided into combined treatment group and control group by random number table method,with 34 cases in each group.The control group was treated with noninvasive mechanical ventilation and budesonide atomization inhalation,and the combined treatment group was treated with salbutamol atomization inhalation on the basis of the control group.The blood gas indexes(arterial partial pressure of carbon dioxide,arterial partial pressure of oxygen,oxygenation index),respiratory mechanics indexes[percentage of maximum volume of first second expiratory(FEV1)in forced vital capacity(FVC),FVC,FEV1],inflammatory factors[interleukin-10(IL-10),interleukin-8(IL-8),interleukin-6(IL-6)],biochemical indexes(C-reactive protein,albumin to globulin ratio)and incidence of adverse reactions were compared between the two groups.Results The oxygenation index and arterial partial pressure of oxygen in the combined treatment group were higher than those in the control group,and the arterial partial pressure of carbon dioxide was lower than that in the control group(P<0.05).FEV1/FVC%,FVC and FEV1in combined treatment group were higher than those in control group(P<0.05).The levels of IL-10,IL-8 and IL-6 in the combined treatment group were lower than those in the control group(P<0.05).The C-reactive protein in the combined treatment group was lower than that in the control group,and the ratio of albumin to globulin was higher than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Salbutamol amine,glucocorticoid combined with noninvasive positive pressure ventilation in the treatm

关 键 词：慢性阻塞性肺疾病 沙丁胺醇 糖皮质激素 血气指标 

分 类 号：R563[医药卫生—呼吸系统]