延续护理对慢性阻塞性肺疾病患者生活质量的影响

目的：研究探究延续护理对慢性阻塞性肺疾病患者生活质量的影响。方法将60名COPD患者随机分为两组,观察组30例,对照组30例,对照组实施常规护理,观察组实施延续护理,六个月后进行其呼吸功能和生活质量的比较。结果经过延续护理,观察组的呼吸比对照组的呼吸改善程度大（P＜0.001）,生活质量高（P＜0.001）。结论延续护理作为一种有效的COPD的护理方式,应该广泛的应用到临床护理工作中去,以提高患者的生活质量,减轻社会负担。     

护理干预对改善慢性阻塞性肺疾病患者生活质量的影响

慢性阻塞性肺疾病属于临床上一种常见的疾病,主要表现在:患者气流受限,伴有不同程度的气道高反应性,病程的时间较长,给患者的身心造成很大负担.相关研究显示,对其进行有效的护理干预,能够有效地改善慢性阻塞性肺疾患者的症状[1].本文作者将本院收治的160例慢性阻塞性肺疾病患者作为研究对象,对其实施护理干预,分析护理干预对慢性阻塞性肺疾病患者生活质量的影响,并作如下报告: 1对象与方法 1.1 对象 对象为2014年5月-2015年4月期间,我院接收的慢性阻塞性肺疾病患者160例,根据住院的先后顺序分为常规组与组,各80例,常规组患者男性46例,女性34例;年龄为44-74岁,平均年龄是(60.3±6.8)岁,常规组患者采用常规护理,组患者男性42例,女性38例;年龄为45-75岁,平均年龄是(61.6士7.3)岁.两组患者在性别、年龄以及病情等临床资料均无明显差异(P＞0.05),具有可比性.     

健康教育对慢性阻塞性肺疾病患者肺通气功能和生活质量的影响

目的探讨健康教育对慢性阻塞性肺疾病（COPD）患者肺通气功能和生活质量的影响。方法 93例COPD患者按住院单、双日分为教育组48例和对照组45例,对照组采用常规护理治疗、体格检查及肺功能复查;教育组在此基础上进行健康教育,6个月,采用COPD生活质量评分表比较两组得分,测定肺通气功能,包括肺活量（FVC）、第1秒用力呼气量（FEV1）和呼气峰流速百分比（PEF%）。结果 （1）教育组6个月后的生活质量总分及多个维度得分较前有显著改善（P〈0.05）,与对照组比较,生活质量总分及各维度得分也有统计学差异（P〈O.05）。（2）教育组FEV1和PEF%改善优于对照组。结论健康教育干预能改善COPD患者的生活质量,提高肺通气功能。     

西宁地区慢性阻塞性肺疾病合并肺栓塞的临床特点

目的：探讨西宁地区慢性阻塞性肺疾病合并肺栓塞的临床特点。方法：分析临床确诊的慢性阻塞性肺疾病合并肺栓塞患者的临床表现及诊治方法。结果：经溶栓后抗凝及单纯抗凝治疗,疗效满意。结论：慢性阻塞性肺疾病合并肺栓塞,较难诊断,极易漏诊及误诊,临床工作中要正确认识其特点。     

西宁地区慢性阻塞性肺疾病患者夜间血氧的观察

目的:观察西宁地区(海拔2 260m)慢性阻塞性肺疾病(COPD)患者夜间血氧水平变化,并探讨其临床意义。方法:30例患者均进行7小时以上夜间睡眠时血氧的监测及日间动脉血气检查。结果:30例病人均有不同程度的夜间低氧血症。结论:COPD患者睡眠时低氧血症是COPD患者病情进展,病情恶化的主要因素。     

老年慢性阻塞性肺疾病患者睡眠质量调查及其影响因素分析

目的 探讨老年慢性阻塞性肺疾病(COPD)患者睡眠质量情况及其影响因素。方法 分析2020年6月-2022年6月收治的老年COPD患者116例资料,对所有患者评估其睡眠质量。根据老年COPD患者睡眠质量评估结果,将其分为睡眠障碍组与睡眠良好组,统计并对比两组性别、年龄、文化程度、合并基础疾病、婚姻状态、病程、吸烟史、是否长期卧床、月收入水平、有无合并睡眠阻塞性呼吸暂停低通气综合征(OSAHS)、气道支持方式、家庭支持度、呼吸困难程度、负面情绪、有无使用利尿剂等资料,分析影响老年COPD患者睡眠质量的危险因素。结果 116例COPD患者经调查发现,有50例存在睡眠障碍,占比为43.10%(50/116)。单因素分析发现,睡眠障碍组长期卧床、合并OSAHS、气道支持方式、家庭支持度低下、mMRC评分≥2分、存在负面情绪、使用利尿剂占比均高于睡眠良好组,差异有统计学意义(P<0.05);两组性别、年龄、文化程度、合并基础疾病、婚姻状态、病程、吸烟史、月收入等对比,差异无统计学意义(P>0.05)。Logistic回归分析：长期卧床、合并OSAHS、气道支持方式、家庭支持度低下、m...     

综合护理干预在改善慢性阻塞性肺疾病生活质量中的应用

目的：分析对于慢性阻塞性肺疾病患者通过运用综合护理干预在改善其生活质量中的临床价值。方法：选取我院2022年1月～2023年5月收治慢阻肺患者70例,通过随机数字表法分组,分为观察组（35例）和对照组（35）例,对照组为常规护理组,观察组在对照组的基础上联合运用综合护理干预,通过心理护理、健康教育、用药指导、营养支持、肺康复训练指导,通过SF-36简明健康简表、匹兹堡睡眠质量量表（PSQI）、Zung心理评估量表（SAS、SDS）对2组患者的生活质量、睡眠状况、精神状态分别进行评估,通过护理满意度评分表对2组患者进行护理满意度调查。结果：施护前SF-36、PSQI评分2组横向比较差异微小P>0.05,施护后与对照组做横向对比SF-36评分为观察组更高,PSQI评分为观察组较低P<0.05;施护前SAS、SDS评分2组横向比较差异微小P>0.05,施护后与对照组做横向对比SAS、SDS评分为观察组较低P<0.05;护理满意度组间横向对比中,观察组100.00%、对照组82.86%,P<0.05。结论：对于慢阻肺患者通过运用综合护理干预能够有效改善其生活质量、...     

慢性阻塞性肺疾病患者的营养支持治疗

21世纪是人类老龄化时代,慢性阻塞性肺疾患(COPD)作为老年人常见病、多发病,随着增龄其病程和治疗也会随之发生变化。据统计,此类疾病中约60％患者的体重低于理想值,其中,肺气肿、肺心病尤为突出,呈蛋白-热量营养不良状态。因此,营养支持治疗也将成为COPD治疗的重要手段,并日益受到人们的重视,本文就此问题综述如下。     

西宁地区慢性阻塞性肺疾病患者D-二聚体检测的意义

目的：分析西宁地区D-二聚体检测,探讨其在慢性阻塞性肺疾病患者中的意义。方法：对西宁地区60例慢性阻塞性肺疾病的D-二聚体进行分析。结果：D-二聚体水平在慢性阻塞性肺疾病加重期患者明显升高,与对照组相比有显著性差异P〈0.01）,治疗后D-二聚体明显下降（P〈0.01）。结论：西宁地区慢性阻塞性肺疾病患者进行D-二聚体水平的监测,在疾病的治疗,改善患者临床预后方面有重要意义。     

剑鞘气管与慢性阻塞性肺疾病的关系

研究剑鞘气管与慢性阻塞性肺疾病之间的关系。材料与方法搜集１９９６－１９９８年有剑鞘气管和ＣＯＰＤ的患者７０例。胸部轴位ＣＴ用１０ｍｍ层厚连续扫描。在主动脉弓上方１０ｍｍ层面测量气管的内冠状径和内矢状径。剑鞘形状的程度用内冠状径与内矢状径的比较来表示。     

Quantitative Computed Tomography of Pulmonary Emphysema and Ventricular Function in Chronic Obstructive Pulmonary Disease Patients with Pulmonary Hypertension

Objective

This study strived to evaluate the relationship between degree of pulmonary emphysema and cardiac ventricular function in chronic obstructive pulmonary disease (COPD) patients with pulmonary hypertension (PH) using electrocardiographic-gated multidetector computed tomography (CT).

Materials and Methods

Lung transplantation candidates with the diagnosis of COPD and PH were chosen for the study population, and a total of 15 patients were included. The extent of emphysema is defined as the percentage of voxels below -910 Hounsfield units in the lung windows in whole lung CT without intravenous contrast. Heart function parameters were measured by electrocardiographic-gated CT angiography. Linear regression analysis was conducted to examine the associations between percent emphysema and heart function indicators.

Results

Significant correlations were found between percent emphysema and right ventricular (RV) measurements, including RV end-diastolic volume (R² = 0.340, p = 0.023), RV stroke volume (R² = 0.406, p = 0.011), and RV cardiac output (R² = 0.382, p = 0.014); the correlations between percent emphysema and left ventricular function indicators were not observed.

Conclusion

The study revealed that percent emphysema is correlated with RV dysfunction among COPD patients with PH. Based on our findings, percent emphysema can be considered for use as an indicator to predict the severity of right ventricular dysfunction among COPD patients.     

Computer-Aided Classification of Visual Ventilation Patterns in Patients with Chronic Obstructive Pulmonary Disease at Two-Phase Xenon-Enhanced CT

Objective

To evaluate the technical feasibility, performance, and interobserver agreement of a computer-aided classification (CAC) system for regional ventilation at two-phase xenon-enhanced CT in patients with chronic obstructive pulmonary disease (COPD).

Materials and Methods

Thirty-eight patients with COPD underwent two-phase xenon ventilation CT with resulting wash-in (WI) and wash-out (WO) xenon images. The regional ventilation in structural abnormalities was visually categorized into four patterns by consensus of two experienced radiologists who compared the xenon attenuation of structural abnormalities with that of adjacent normal parenchyma in the WI and WO images, and it served as the reference. Two series of image datasets of structural abnormalities were randomly extracted for optimization and validation. The proportion of agreement on a per-lesion basis and receiver operating characteristics on a per-pixel basis between CAC and reference were analyzed for optimization. Thereafter, six readers independently categorized the regional ventilation in structural abnormalities in the validation set without and with a CAC map. Interobserver agreement was also compared between assessments without and with CAC maps using multirater κ statistics.

Results

Computer-aided classification maps were successfully generated in 31 patients (81.5%). The proportion of agreement and the average area under the curve of optimized CAC maps were 94% (75/80) and 0.994, respectively. Multirater κ value was improved from moderate (κ = 0.59; 95% confidence interval [CI], 0.56-0.62) at the initial assessment to excellent (κ = 0.82; 95% CI, 0.79-0.85) with the CAC map.

Conclusion

Our proposed CAC system demonstrated the potential for regional ventilation pattern analysis and enhanced interobserver agreement on visual classification of regional ventilation.     

慢性阻塞性肺部病变患者肺部CT灌注成像特征

目的探讨慢性阻塞性肺疾病(COPD)患者肺部CT灌注成像的时间密度曲线(TDC)和灌注参数特征。方法共44例,分为COPD组25例及对照组19例。均行肺部多层螺旋CT(MSCT)动态增强扫描。图像经后处理,设定感兴趣区(右腹肺、右背肺和左腹肺、左背肺),得到各处肺组织TDC和灌注参数,包括灌注值(P),强化峰值增量(PEI),达峰值时间(TTP)和血容量(BV)。比较分析COPD组和对照组的TDC特征,以及各灌注参数的差异性。结果COPD组较对照组TDC波峰延后。各灌注参数腹背肺比率在2组无显著性差异(P>0.05)。COPD组TTP较对照组明显延长(P=0.010)。P、PEI和BV在2组无显著性差异(P>0.05)。结论CT灌注成像显示COPD患者肺部血流灌注异常主要表现为TDC波峰延后,TTP延长。     

综合干预措施对慢性阻塞性肺病的临床意义

目的探讨综合干预措施对慢性阻塞性肺病的临床价值。方法将100例符合COPD诊断标准的患者随机分成两组。一组采用综合干预措施(包括COPD知识的定期咨询和宣传教育,流感疫苗,肺炎疫苗的接种。同时吸入布地奈德400μg/d,福莫特罗9~18μg/d,及必要的家庭氧疗)。另一组常规处理(对照组)。结果干预组的住院率由干预前19.5%下降至5.5%(P<0.05),而对照组则无明显下降。干预组患者急性加重住院时间(11.5±5)d,而对照组则为(20.4±3)d,两组相比差异有统计学意义(P<0.05)。干预组戒烟40例(80%),对照组只有10例(20%),两组比较有统计学差异(P<0.05)。干预组生活质量评分低于对照组,两组比较差异有统计学意义(P<0.05)。结论对COPD患者进行综合干预有重要临床意义。     

医院对COPD稳定期患者行无创通气的适用性研究

目的探讨稳定期慢性阻塞性肺疾病（COPD）患者行无创通气的治疗效果。方法选择稳定期慢性阻塞性肺疾病患者30例分为两组,实验组12例,对照组18例。对照组采用常规治疗,实验组在常规治疗基础上加无创通气呼吸机治疗,4h／d。结果实验组与对照组比较,两组治疗前呼吸困难评分、6分钟步行实验、圣乔治评分没有统计学差异,P〉0．05,治疗后P〈0．05,两组差别显著,实验组好于对照组。结论稳定期COPD患者医院行无创通气有较好临床效果。     

Assessment of the Right Ventricular Function and Mass Using Cardiac Multi-Detector Computed Tomography in Patients with Chronic Obstructive Pulmonary Disease

Objective

We wanted to assess the relationship between measurements of the right ventricular (RV) function and mass, with using cardiac multi-detector computed tomography (MDCT) and the severity of chronic obstructive pulmonary disease (COPD) as determined by the pulmonary function test (PFT).

Materials and Methods

Measurements of PFT and cardiac MDCT were obtained in 33 COPD patients. Using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, the patients were divided into three groups according to the severity of the disease: stage I (mild, n = 4), stage II (moderate, n = 15) and stage III (severe, n = 14). The RV function and the wall mass were obtained by cardiac MDCT. The results were compared among the groups using the Student-Newman-Keuls method. Pearson''s correlation was used to evaluate the relationship between the right ventricular ejection fraction (RVEF) and the wall mass results with the PFT results. P-values less than 0.05 were considered statistically significant.

Results

The RVEF and mass were 47±3% and 41±2 g in stage I, 46±6% and 46±5 g in stage II, and 35±5% and 55±6 g in stage III, respectively. The RVEF was significantly lower in stage III than in stage I and II (p < 0.01). The RV mass was significantly different among the three stages, according to the disease severity of COPD (p < 0.05). The correlation was excellent between the MDCT results and forced expiratory volume in 1 sec (r = 0.797 for RVEF and r = -0.769 for RV mass) and forced expiratory volume in 1 sec to the forced vital capacity (r = 0.745 for RVEF and r = -0.718 for RV mass).

Conclusion

Our study shows that the mean RV wall mass as measured by cardiac MDCT correlates well with the COPD disease severity as determined by PFT.     

慢性阻塞性肺病急性加重患者膈肌影像变化

目的 研究慢性阻塞性肺病(COPD)急性加重患者膈肌影像变化,为选择合适的肺康复方式提供参考.方法 36例COPD急性加重患者行平板数字化X线摄影系统和肺功能检查,组间差异分析采用单因素方差分析,膈肌移动度与残气量之间采用Peanon相关分析.结果 GOLD 2级与GOLD 4级患者膈肌移动度和膈肌角度之间有显著性差异.膈肌移动度与残气量为负相关(r=-0.82,P=0.003).结论 平板数字化X线摄影膈肌参数与肺功能检查结果之间有很好的相关性,可用于评估患者肺功能.     

慢性阻塞性肺疾病病人机械通气时内源性呼气末正压测定

目的：测定慢性阻塞性肺疾病（ＣＯＰＤ）患者机械通气时的内源性呼气末正压（ＰＥＥＰｉ）。方法：应用呼气末阻断法测定了３６例ＣＯＰＤ患者机械通气时的ＰＥＥＰｉ。结果：１５例中度ＣＯＰＤ病人中的７例和２１例重度ＣＯＰＤ病人中的１８例存在ＰＥＥＰｉ。两组间Ｐ＜０．０１。结论：ＣＯＰＤ病人机械通气时应常规测量ＰＥＥＰｉ，加强气道管理，调整通气模式和参数，可提高通气治疗疗效。     

苏子降气汤治疗慢阻肺的肺功能观察

目的：对苏子降气汤治疗慢阻肺的肺功能的临床疗效进行探讨。方法随机抽取2011年10月～2013年12月治疗的60例慢性阻塞性肺疾病患者,分为对照组与观察组,对照组患者使用西医常规进行治疗,观察组患者使用苏子降气汤进行治疗,对两组患者的临床疗效进行对比与分析。结果观察组患者的治疗有效率明为96．7％,对照组为73．3％,存在较大差异,具备统计学意义（ P＜0．05）。两组患者在接受治疗后, FEV1、FVC、FEV1／FVC均明显改善,且观察组优于对照组,存在较大差异,具备统计学意义（ P＜0．05）。结论苏子降气汤在慢性阻塞性肺病治疗中的应用,有效提高了患者的临床治疗有效率,改善患者的肺功能,抑制细菌的滋生,缩短药力的输送与发挥药效时间,临床使用价值较高。