【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。更多还原

【Abstract】 Objective To observe the effect of aerosol inhalation of salbutamol combined with noninvasive 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,with40 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 the ΔFEV₁ or its improvement rate between the two groups（ P>0.05）. The ΔFVC 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 safety.更多还原