摘要
目的研究机械辅助排痰与糖皮质激素联合疗法在慢性阻塞性肺疾病(COPD)急性加重期患者中的疗效。方法选取三明市第二医院2023年9月至2024年6月诊疗的急性加重期COPD患者90例,以随机数字表法分成两组,对照组和观察组各45例。两组入院后均进行对症处理,对照组在对症处理的基础上增加布地奈德治疗,观察组在对症处理的基础上增加机械辅助排痰联合糖皮质激素治疗。比较对照组和观察组治疗前后的动脉血气指标[pH、动脉血二氧化碳分压(PaCO_(2))和动脉血氧分压(PaO_(2))]、炎症因子[白细胞介素-6(IL-6)、C反应蛋白(CRP)和降钙素原(PCT)]和病情程度[慢性阻塞性肺疾病评估测试呼吸问卷(CAT)],同时统计两组临床治疗有效情况。结果治疗后,观察组PaO_(2)、pH水平比对照组高,且PaCO_(2)水平比对照组低(P<0.05);观察组IL-6、CRP和PCT水平均低于对照组,且两组均较治疗前下降(P<0.05)。对照组临床治疗总有效率为77.78%(35/45),低于观察组的95.56%(43/45)(P<0.05)。治疗后,观察组CAT评分比对照组低(P<0.05)。结论在急性加重期COPD患者中,实施机械辅助排痰配合糖皮质激素综合治疗方案,可以有效缓解炎症,优化血液指标结果,降低病情严重程度,增强临床效果。
Objective To study the efficacy of the combined therapy of mechanical assisted sputum expectoration and glucocorticoids in patients with acute exacerbation of COPD.Methods A total of 90 patients with acute exacerbation of COPD treated at Sanming Second Hospital from September 2023 to June 2024 were selected and randomly divided into two groups,with 45 cases in each group.Both groups received symptomatic treatment upon admission,the control group was treated with budesonide on the basis of symptomatic treatment,and the observation group was treated with mechanical assisted sputum expectoration combined with corticosteroid therapy on the basis of symptomatic treatment.The arterial blood gas indicators(pH,PaCO_(2)and PaO_(2)),inflammatory factors[interleukin-6(IL-6),C-reactive protein(CRP),and procalcitonin(PCT)],and disease severity[Chronic Obstructive Pulmonary Disease Assessment Test(CAT)]were compared before and after treatment between the two groups,and the clinical treatment effectiveness was statistically analyzed.Results After treatment,compared with the control group,the observation group had higher levels of PaO_(2)and pH,and lower levels of PaCO_(2)(P<0.05).After treatment,compared with the control group,the levels of IL-6,CRP,and PCT in the observation group were all lower(P<0.05).The total effective rate of clinical treatment in the control group was 77.78%,lower than the observation group’s 95.56%(P<0.05).After treatment,compared with the control group,the CAT score in the observation group was lower than that in the control group(P<0.05).Conclusions The application of mechanical assisted sputum expectoration combined with corticosteroid therapy in patients with acute exacerbation of COPD helps to reduce inflammatory responses,improve blood gas indicators,reduce the severity of the disease,and enhance clinical effectiveness.
作者
李梁燕
LI Liangyan(Department of Respiratory and Critical Care Medicine,Sanming Second Hospital,SanMing 366000,China)
出处
《中国医药指南》
2024年第35期20-23,共4页
Guide of China Medicine
关键词
慢性阻塞性肺疾病
辅助排痰
急性加重期
糖皮质激素
Chronic obstructive pulmonary disease
Assist in expectoration
Acute exacerbation
Corticosteroids
