支气管舒张药物联合用于慢性阻塞性肺疾病合并呼吸衰竭的疗效及安全性

目的 探讨支气管舒张药物联合用于治疗慢性阻塞性肺疾病（COPD）合并呼吸衰竭的疗效及安全性.方法 将深圳市龙岗区第三人民医院于2012年3月至2014年3月收治的62例COPD合并呼吸衰竭患者按Doll＇s随机数字表法分为观察组和对照组,各31例.对照组给予持续吸氧和内科药物治疗等常规治疗,观察组在对照组基础上联合使用硫酸沙丁胺醇气雾剂和异丙托溴铵气雾剂治疗.比较2组患者治疗效果、血气分析指标、住院时间及不良反应发生率.结果 观察组有效率[96.8％ （30/31）]高于对照组[83.9％（26/31）],差异有统计学意义（P =0.038）.治疗后,观察组氧分压[（70±6）mmHg（1 mmHg =0.133 kPa）]高于治疗前[（48 ±6）mmHg]和对照组同时间[（60±10）mmHg],二氧化碳分压[（42±5）mmHg]低于治疗前[（64 ±8）mmHg]和对照组同时间[（46±7）mmHg],差异均有统计学意义（均P＜0.05）.对照组平均住院时间长于观察组[（18.7±3.0）d比（15.1±1.8）d],差异有统计学意义（P＜0.05）.对照组与观察组的不良反应发生率比较[16.1％ （5/31）比25.8％ （8/31）],差异无统计学意义（P＞0.05）.结论 支气管舒张药物联合应用可明显改善COPD合并呼吸衰竭患者的临床症状和血气参数,有效缩短患者的住院时间.

Therapeutic effect and security of multiple bronchodilators treating chronic obstructive pulmonary diseases complicated with respiratory failure

Objective To explore the therapeutic effect and security of multiple bronchodilators treating chronic obstructive pulmonary diseases（COPD） complicated with respiratory failure.Methods Sixty-two cases of COPD with respiratory failure were divided into two groups according to the Doll＇s random number table method.31 cases were in control group and had conventional therapy,including persistent oxygen inspiration and drug treatment.Other 31 cases were in observer group and had multiple bronchodilators on the basis of conventional therapy.The changes of clinical symptoms,parameters of blood gas,adverse drug actions and hospital stays were compared.Results The effective rate of observation group [96.8% （30/31）] was higher than that of the control group [83.9% （26/31）],the difference was statistically significant （P =0.038）.After treatment,the oxygen tension of observation group [（70 ±6）mmHg] was higher than that of the control group[（60 ± 10）mmHg],the partial pressure of carbon dioxide of observation group [（42 ± 5） mmHg] was lower than that of the control group [（46 ± 7） mmHg],the difference were statistically significant differences（all P 〈 0.05）.The average stay of the control group was longer than that of the observation group[（18.71 ± 3.0） d vs （15.1 ± 1.8） d],the difference was statistically significant（P 〈 0.05）.The differences of incidence of adverse reaction of the control group and observation group showed no significance [16.1% （5/31） vs 16.1% （8/31）,P 〉 0.05].Conclusion The combined application of bronchodilator can obviously improve the clinlcal symptom,decrease the time in hospital,has better curative effect of the COPD patients complicated with respiratory failure.