布地奈德混悬液联合复方异丙托溴铵雾化吸入治疗对慢性阻塞性肺疾病急性加重期疗效观察

陈梅鹃; 王滔; 王利

doi:10.3969/j.issn.2095-5227.2018.10.011

布地奈德混悬液联合复方异丙托溴铵雾化吸入治疗对慢性阻塞性肺疾病急性加重期疗效观察

Budesonide suspension combined with compound ipratropium bromide in treatment of acute exacerbation of chronic obstructive pulmonary disease

摘要

摘要: 目的研究布地奈德混悬液联合复方异丙托溴铵对慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease，AECOPD)疗效。方法选取我院2016年4月- 2018年4月收治的AECOPD患者106例，采用随机数字法将其分为对照组和观察组，每组各53例。所有患者均接受抗感染、止咳化痰、平喘、吸氧等常规综合治疗，在此基础上，观察组患者雾化吸入复方异丙托溴铵和布地奈德混悬液治疗。比较两组的治疗总有效率和症状体征消失时间，同时比较治疗前后的肺功能和动脉血气水平。结果观察组治疗总有效率(94.34%)明显高于对照组(75.47%)(χ²=7.36，P=0.00)，观察组咳嗽、气促、喘憋及肺部啰音等症状消失时间分别为(2.17±0.75) d、(2.63±0.86) d、(2.72±0.87) d、(4.76±1.41) d，均明显低于对照组的(3.55±0.82) d、(4.30±0.95) d、(4.88±1.03) d、(7.05±1.74) d (P均＜ 0.05)；治疗后，观察组的FEV₁、FEV₁/FVC及PEF等肺功能指标分别为(1.98±0.63) L、(72.47±6.69)%、(6.08±1.20) L/s，均明显高于对照组的(1.73±0.56) L、(60.93±6.85)%、(5.11±1.04) L/s (P均＜ 0.05)，动脉血PaCO₂水平为(43.08±4.76) mmHg (1 mmHg=0.133 kPa)，明显低于对照组的(52.26±5.49) mmHg (P＜0.05)，PaO₂水平为(81.05±8.23) mmHg，明显高于对照组的(69.13±7.46) mmHg(P＜0.05)。结论布地奈德混悬液联合复方异丙托溴铵雾化吸入治疗AECOPD疗效显著，可促进患者症状体征恢复，纠正动脉血气紊乱，改善患者肺功能，值得临床推广。

Abstract: Objective To study the effectiveness of budesonide suspension combined with compound ipratropium bromide in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Patients with AECOPD were enrolled from April 2016 to April 2018 in our hospital, and randomly divided into control group and observation group with 53 cases in each group. All patients received routine comprehensive treatment to control infection, relieve cough, reduce sputum, and relieve asthma. On this basis, the observation group received atomized inhalation of compound ipratropium bromide and budesonide suspension. The total effective rate, time to symptoms and signs disappearing, pulmonary function and arterial blood gas level before and after treatment were compared between two groups. Results The total effective rate of observation group was 94.34%, which was significantly higher than that of control group (75.47%) (χ²=7.36, P=0.00). The time to symptoms and signs disappearing in observation group was significantly lower than that of control group cough, (2.17±0.75) d vs (3.55±0.82) d; shortness of breath, (2.63±0.86) d vs (4.30±0.95) d; wheezing, (2.72±0.87) d vs (4.76±1.41) d; rale of lung, (4.88±1.03) d vs (7.05±1.74) d(all P＜ 0.05). After treatment, the pulmonary function indexes such as FEV₁, FEV₁/FVC and PEF in the observation group were significantly higher than the control group FEV₁, (1.98±0.63) L vs (1.73±0.56) L; FEV₁/FVC, (72.47±6.69)% vs (60.93±6.85)%; PEF, (6.08±1.20) L/s vs (5.11±1.04) L/s, all P＜ 0.05, and the level of PaCO₂ in arterial blood was significantly lower than the control group (43.08±4.76) mmHg vs (52.26±5.49) mmHg, P＜ 0.05. The level of PaO₂ in the obsercation group was significantly higher than that in the control group (81.05±8.23) mmHg vs (69.13±7.46) mmHg, P ＜ 0.05. Conclusion Budesonide suspension combined with compound ipratropium bromide atomization inhalation is effective in the treatment of AECOPD. It can promote the recovery of symptoms and signs, correct the disorder of arterial blood gas and improve the pulmonary function of patients, which is worthy of popularizing in clinical practice.

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