【摘要】 目的探讨高压氧驱动雾化吸入沙丁胺醇、布地奈德及氨溴索治疗慢性阻塞性肺疾病急性发作(AECOPD)的临床疗效。方法将舞阳县人民医院于2009年1月至2011年6月收治的明确诊断为AECOPD的108例患者随机分为治疗组和对照组各54例。两组在常规应用抗生素、祛痰、平喘药物、补液、氧疗等治疗基础上,对照组加用沙丁胺醇雾化溶液1 ml,2次/d,经高压氧驱动雾化吸入;治疗组加用沙丁胺醇、布地奈德及氨溴索联合雾化吸入,其中沙丁胺醇雾化溶液和布地奈德混悬液每次各1 ml,2次/d,氨溴索每次2 ml,2次/d,经高压氧驱动雾化吸入。氧流量5～8 L/min,两组疗程均为7 d。比较两组患者治疗前后动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、动脉血氧饱和度(SaO2)、第一秒用力呼气容积(FEV1)及FEV1/FVC(用力肺活量)等血气指标、肺功能变化情况并比较两组间治疗后的差异。结果治疗7 d后,两组患者的血气指标、肺功能均优于治疗前,差异有统计学意义(P<0.05);两组间比较,治疗组患者的上述指标均优于对照组,差异有统计学意义(P<0.05)。结论高压氧驱动雾化吸入沙丁胺醇、布地奈德联合氨溴索治疗AECOPD患者,可以有效改善患者的血气指标及肺功能,值得临床推广应用。更多还原

【Abstract】 Objective To investigate the clinical effect of hyperbaric oxygen drived atomizing inhalation of salbutamol,budesonide and ambroxol on acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods From January 2009 to June 2011,108 patients with AECOPD were randomly divided into the treatment group and the control group,with 54 cases in each group.Both groups recieved routine use of antibiotics,eliminate sputum,antiasthmatic drugs,content,rehydration,oxygen therapy.In addition,the control group recieved salbutamol atomized solution 1 ml,2 times every day,driven by hyperbaric oxygen aerosolized;The treatment group recieved atomizing inhalation of salbutamol,budesonide and ambroxol,including salbutamol atomized solution and budesonide suspension liquid every time each 1 ml,ambroxol every time 2 ml,2 times every day,driven by hyperbaric oxygen aerosol inhalation.Oxygen flow was 5-8 L/min,the treatment course was 7 days.PaO2,PaCO2,SaO2,the first second(FEV1),FEV1/FVC(FEV1 value of expected percentage) and other indexes,pulmonary function were compared before and after the treatment,and compare the differences between the two groups.Results Seven days after treatment,all indexes were better than those before treatment,there were significant differences(P<0.05),and the indexes in the treatment group were better than those in the control group,there were significant differences(P<0.05).Conclusion Hyperbaric oxygen drived atomizing inhalation of salbutamol,budesonide combined with ambroxol in treatment of AECOPD,can effectively improve the blood-gas indexes and lung function,and is worth clinical application.更多还原