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1.
目的观察呋塞米注射液在新生儿湿肺中的疗效。方法选取2018年1月—2019年12月医院新生儿科收治的新生儿湿肺70例,随机分为试验组35例和对照组35例,二组性别、胎龄、出生体质量、生产方式的差异无统计学意义(P>0.05),试验组在对照组常规治疗的同时加用静注呋塞米注射液0.5 mg/(kg·d),疗程3 d,比较两组平均住院时间、停氧时间、48小时内症状缓解例数。结果平均住院时间:试验组(5.00±1.31)d,对照组(6.06±1.75)d;总用氧时间:试验组(49.04±18.23)h,对照组(63.80±24.11)h;48 h内呼吸症状改善者:试验组24例(68.57%),对照组15例(42.86%),二组比较在平均住院时间、总用氧时间及48小时内症状缓解例数,差异均有统计学意义(P<0.05)。结论呋塞米注射液治疗新生儿湿肺在平均住院时间、总用氧时间和48小时内呼吸症状缓解优于对照组,有一定的疗效。  相似文献   
2.
目的探讨联合检测二维超声心动图、B型脑钠肽(BNP)、6 min步行试验(6WMT)、呼吸困难量表(MMRC)对慢性阻塞性肺疾病急性加重期(AECOPD)患者右心功能不全的诊断意义。 方法选取2016年5月至2018年5月我院急诊科收治临床确诊的AECOPD患者作为研究对象,分别收集患者一般资料及进行BNP、6MWT、MMRC、二维超声心动图实验指标测定,统计学分析二维超声心动图指标与BNP、6MWT、MMRC联合检测对AECOPD患者右心功能不全的诊断差异。 结果共收集AECOPD患者249例,以四项试验指标中任一项阳性结果判断入组患者右心功能不全,则阳性94例(37.8%),正常者155例(62.2%)。统计学分析,显示二维超声心动图与BNP、6MWT、MMRC判定AECOPD患者发生右心功能不全之间有统计学差异(P<0.05),二维超声心动图指标与BNP、6MWT、MMRC中任一项联合检测,二维超声指标+BNP组合优于其他组合(同时阳性和同时阴性所占百分比分别为:67.9%,42.6%,54.2%)。二维超声心动图指标联合BNP、6MWT、MMRC中任两项检测,BNP+6MWT+二维超声指标优于其他组合(结果同时阳性和同时阴性所占百分比分别为:44.6%,36.1%,42.2%)。 结论联合检测二维超声心动图、BNP、6WMT、MMRC对AECOPD患者右心功能不全诊断效果优于单一检测指标,其中BNP+超声指标组优于其他组合,可作为COPD患者合并右心功能不全诊断首选组合方案。  相似文献   
3.
ContextNonpharmacological approaches are effective strategies for difficult to palliate breathlessness. Although acupuncture is effective for dyspnea in early-stage chronic obstructive pulmonary disease (COPD), little is known about its effects in patients with advanced (non)malignant diseases.ObjectivesThe objective of this study was to identify and examine the evidence of acupuncture on breathlessness in advanced malignant and nonmalignant diseases.MethodsSystematic literature review of randomized controlled trials of acupuncture and acupressure searched in five databases. Included were adult participants with at least 25% having advanced diseases such as cancer or COPD with severe breathlessness. Primary outcome was severity of dyspnea on Visual Analogue Scale or Borg Scale. Secondary outcomes included quality of life, function, and acceptability. Data were pooled using a random effects model of standardized mean differences.ResultsTwelve studies with 597 patients (347 COPD, 190 advanced cancer) were included. For breathlessness severity, significant differences were obtained in a meta-analysis (10 studies with 480 patients; standardized mean difference (SMD) = −1.77 [95% CI −3.05, −0.49; P = 0.007; I2 = 90%]) and in a subgroup analysis of using sham acupuncture control groups and a treatment duration of at least three weeks (6 studies with 302 patients; SMD = −2.53 [95% CI −4.07, −0.99; P = 0.001; I2 = 91%]). Exercise tolerance (6-minute walk test) improved significantly in the acupuncture group (6 studies with 287 patients; SMD = 0.93 [95% CI 0.27, 1.59; P = 0.006; I2 = 85%]). In four of six studies, quality of life improved in the acupuncture group.ConclusionAcupuncture improved breathlessness severity in patients with advanced diseases. The methodological heterogeneity, low power, and potential morphine-sparing effects of acupuncture as add-on should be further addressed in future trials.  相似文献   
4.
Although pulmonary arteriovenous malformations (PAVM) are relatively rare in children, they are important in the differential diagnosis of common pulmonary problems, such as hypoxemia, hemoptysis and dyspnea on exertion. We report the cases of two PAVM patients with different presentations and describe the treatment strategies.  相似文献   
5.

Background

Poor exercise tolerability is a major barrier to improving the quality of life of patients with chronic obstructive pulmonary disease (COPD). Although COPD is often treated with long-acting β2 adrenergic agonists, few studies have examined their effects on exercise tolerability.

Methods

In this study, Japanese COPD patients were treated with 2 mg transdermal tulobuterol, a long-acting β2 agonist, once daily for 4 weeks. Spirometry and exercise tests were conducted at baseline and at the end of treatment. The patients conducted constant load (30 W for 5 min) and incremental load (starting at 10 W and increasing by 10 W every 1 min for 5 min to a maximum load of 50 W) exercise tests on a cycle ergometer.

Results

Thirteen patients with stable COPD participated in this study (mean age ± standard deviation (SD), 69.5±9.7 years; smoking history 55.9±27.8 pack-years). Resting spirometric parameters were unchanged at the end of treatment. The maximum Borg scale for dyspnea and the Borg scale slope (BSS) decreased significantly from baseline to the end of treatment. The threshold load of dyspnea (TLD) increased slightly, although not significantly, in the constant load test but not in the incremental load test. There were no changes in respiratory parameters during exercise after treatment.

Conclusions

In conclusion, we found that treatment with transdermal tulobuterol for 4 weeks improved self-assessed dyspnea in Japanese COPD patients during constant and incremental exercise tests. This improvement in dyspnea may encourage patients to perform daily life activities or regular physical activity.  相似文献   
6.
Platypnea-orthodeoxia syndrome is an uncommon condition of positional dyspnea and hypoxemia; symptoms occur when the patient is upright and resolve with recumbency. Causes can be broadly categorized into 4 groups: intracardiac shunting, pulmonary shunting, ventilation-perfusion mismatch, or a combination of these.Platypnea-orthodeoxia syndrome should be suspected when normal arterial oxygen saturations are recorded while an individual is supine, followed by abrupt declines in those saturations when upright. Further investigations with use of imaging and cardiac catheterization aid in the evaluation. When platypnea-orthodeoxia syndrome is due to intracardiac shunting without pulmonary hypertension, intracardiac shunt closure can be curative.In this article, we report a case of platypnea-orthodeoxia syndrome in an 83-year-old woman who was successfully treated by means of percutaneous transcatheter closure of an atrial septal defect.  相似文献   
7.
Objectives: The purpose of this study was to evaluate detailed ventilatory, cardiovascular and sensory responses to cycle exercise in sedentary patients with well-controlled asthma and healthy controls. Methods: Subjects included sedentary patients meeting criteria for well-controlled asthma (n?=?14), and healthy age- and activity-matched controls (n?=?14). Visit 1 included screening for eligibility, medical history, anthropometrics, physical activity assessment, and pre- and post-bronchodilator spirometry. Visit 2 included spirometry and a symptom limited incremental cycle exercise test. Detailed ventilatory, cardiovascular and sensory responses were measured at rest and throughout exercise. Results: Asthmatics and controls were well matched for age, body mass index and physical activity levels. Baseline forced expiratory volume in 1?second (FEV1) was similar between asthmatics and controls (98?±?10 versus 95?±?9% predicted, respectively, p?>?0.05). No significant differences were observed between asthmatics and controls for maximal oxygen uptake (31.8?±?5.6 versus 30.6?±?5.9?ml/kg/min, respectively, p?>?0.05) and power output (134?±?35 versus 144?±?32?W, respectively, p?>?0.05). Minute ventilation (VE) relative to maximum voluntary ventilation (VE/MVV) was similar between groups at maximal exercise with no subjects showing evidence of ventilatory limitation. Asthmatics and controls achieved similar age-predicted maximum heart rates (92?±?7 versus 93?±?8% predicted, respectively, p?>?0.05). Ratings of perceived breathing discomfort and leg fatigue were not different between groups throughout exercise. Conclusions: The results of this study indicate that sedentary patients with well-controlled asthma have preserved sensory and cardiorespiratory responses to exercise with no evidence of exercise impairment or ventilatory limitation.  相似文献   
8.
A 55‐year‐old woman presented with severe dyspnea during acceleration‐dependent left bundle branch block (LBBB). Metoprolol initially ameliorated symptoms by preventing the heart rate at which LBBB occurred. Over time LBBB presented at slower heart rates and the patient developed recurrent dyspnea during an activity that correlated with the development of LBBB on event monitors and exercise stress testing. A biventricular pacemaker was implanted, and the patient's symptoms remain resolved after a follow‐up of over 4 years. More research is needed to define the use of cardiac resynchronization therapy in patients with normal heart function.  相似文献   
9.
目的研究中西医结合治疗慢性支气管炎急性发作的效果。方法选取2018年11月-2019年11月就诊的60例慢性支气管炎急性发作期患者作为此次研究的对象,其中2018年11月-2019年4月到院的30例患者归为对照组,予以常规西医给药治疗;2019年4月-2019年11月到院的30例患者归为观察组,在对照组的基础身上予以清化止咳汤治疗,对比2组的临床疗效、不良症状改善的时间变化情况及不良反应的发生情况。结果观察组患者的临床总有效率(93.33%)显著高于对照组(73.33%)(P<0.05)。观察组患者不良症状改善的时间均短于对照组(P<0.05)。观察组患者的不良反应发生率(6.67%)显著低于对照组(26.67%)(P<0.05)。结论予以慢性支气管炎急性发作期患者中西结合治疗,能够有效的减轻其临床症状,使不良症状能够更快速的得到改善,并且减少不良反应的发生现象,进一步提高患者身体健康的恢复。  相似文献   
10.
目的:探析经面罩无创通气在慢性阻塞性肺疾病合并呼吸衰竭患者中应用效果.方法:在本院2017年9月~2018年12月收治的慢性阻塞性肺疾病合并呼吸衰竭患者中选出138例为观察对象,根据治疗方法分组,对照组患者给予常规治疗,观察组在对照组基础上给予经面罩无创通气(BiPAP无创正压通气).结果:治疗24h后两组动脉血气指标以及呼吸频率均明显好转,P<0.05;治疗24h后的PaCO2、PaO2和呼吸频率对比,观察组均好于对照组,P<0.05;治疗24h后的pH组间比较差异无统计学意义,P>0.05;观察组的住院时间和治疗3d、治疗7d后的呼吸困难发生率均低于对照组,P<0.05.结论:经面罩无创通气治疗可快速缓解慢阻肺合并呼吸衰竭患者的通气换气障碍,提高治疗效果.  相似文献   
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