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目的探讨雾化吸入氨溴索联合机械振动排痰对慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者的临床效果。方法 AECOPD患者60例,随机分为对照组:氨溴索雾化组;实验组:氨溴索(30 mg,3/d)雾化治疗联合机械振动排痰组,每组各30例。两组患者均给予常规治疗。观察治疗前后两组患者日均排痰量、动脉血气指标[动脉氧分压(partial pressure of oxygen in artey,PaO2)和动脉血二氧化碳分压(partial pressure of carbon doxide in artey,PaCO2)]及肺功能指标[第1秒用力呼气容积(forced expiratory volume in one second,FEV1)/用力肺活量(forced vital capacity,FVC)(简称一秒率FEV1/FVC%)和FEV1],比较两组患者血白细胞恢复正常天数及住院总天数的差异。结果实验组前3天日均排痰量较对照组比较明显增多(P<0.05),第4~7天日均排痰量则较对照组比较明显减少(P<0.05);实验组第3天血气指标PaO2和PaCO2、1周后肺功能指标(FEV1/FVC%和FEV1)及血白细胞恢复正常天数、住院总天数较对照组均明显改善(均P<0.05)。结论雾化吸入氨溴索联合机械振动排痰对AECOPD患者促排痰效果更显著,能改善肺通气及氧合功能,减轻炎症反应,明显缩短住院时间。
Objective To investigate the clinical effect of inhalation of ambroxol combined with mechanical vibration and expectoration on patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods AECOPD 60 patients were randomly divided into control group: ambroxol atomized group; experimental group: ambroxol (30 mg, 3 / d) atomization combined with mechanical vibration phlegm group, 30 cases in each group. Both groups were given routine treatment. The daily sputum volume, arterial blood gas index [partial pressure of oxygen in artey (PaO2) and partial pressure of carbon dioxide in artey (PaCO2)] and lung The levels of blood leukocytes in two groups were compared between forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) and FEV1 The difference between the normal days and the total days of hospitalization. Results The amount of sputum per day in the first three days of the experimental group was significantly increased compared with the control group (P <0.05), and the daily sputum output was significantly decreased on the 4th to 7th days compared with the control group (P <0.05) The indexes of pulmonary function (FEV1 / FVC% and FEV1), normal days of white blood cells recovery and days of hospitalization after PaO2 and PaCO2 were significantly improved compared with those of control group (all P <0.05). Conclusion Atomized inhalation of ambroxol combined with mechanical vibration phlegm on patients with AECOPD to promote sputum expectoration effect is more significant, can improve pulmonary ventilation and oxygenation function, reduce inflammation, significantly shorten the hospital stay.