论文部分内容阅读
目的探讨噻托溴铵吸入剂联合无创正压通气(NIPPV)治疗慢性阻塞性肺疾病急性加重期(AECOPD)对患者肺功能、C反应蛋白(CRP)的影响。方法选择AECOPD患者76例,随机分为观察组和对照组各38例,所有病例均予以常规治疗(抗炎、祛痰、平喘、吸氧、纠正酸碱失衡及水电解质紊乱、营养支持和对症处理),观察组在此基础上予噻托溴铵吸入剂(每日晨间1吸,每次18μɡ)及NIPPV治疗,疗程20 d。观察两组治疗前后肺功能(FEV1%、FEV1/FVC)及CRP水平等变化。结果观察组肺功能FEV1%、FEV1/FVC较对照组明显改善(P均<0.05);血清CRP水平较对照组下降(P<0.01);有效率(86.8%)稍高于对照组(78.9%),但差异无统计学意义(P>0.05);气管插管率(13.2%)稍低于对照组(26.3%),但差异无统计学意义(P>0.05);而住院天数明显低于对照组[(13±4.8)d vs(25±3.8)d,P<0.05]。结论噻托溴铵吸入剂联合NIPPV治疗AECOPD,可提高患者肺功能、降低血清CRP水平、改善临床症状、缩短住院天数,有较高的临床应用价值。
Objective To investigate the effects of Tiotropium bromide inhalation combined with noninvasive positive pressure ventilation (NIPPV) on pulmonary function and C-reactive protein (CRP) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods AECOPD patients 76 cases were randomly divided into observation group and control group 38 cases, all cases were routine treatment (anti-inflammatory, expectorant, asthma, oxygen, correct acid-base imbalance and water and electrolyte imbalance, nutritional support and Symptomatic treatment), the observation group on this basis to tiotropium inhalation (daily suck a morning, 18μɡ each) and NIPPV treatment, treatment of 20 d. The changes of pulmonary function (FEV1%, FEV1 / FVC) and CRP level before and after treatment were observed. Results The FEV1% and FEV1 / FVC of lung function in observation group were significantly improved compared with control group (all P <0.05); serum CRP level was lower than that of control group (P <0.01); the effective rate (86.8%) was slightly higher than that of control group ), But the difference was not statistically significant (P> 0.05); tracheal intubation rate (13.2%) was slightly lower than that of the control group (26.3%), but the difference was not statistically significant (P> 0.05) The control group [(13 ± 4.8) d vs (25 ± 3.8) d, P <0.05]. Conclusion Tiotropium bromide inhalation combined with NIPPV in the treatment of AECOPD can improve lung function, reduce serum CRP level, improve clinical symptoms, shorten the length of stay, and have high clinical value.