Longitudinal study of lung function development in a cohort of Indian medical students: interaction of respiratory allergy and smoking

This study was done to identify some factors that affect the growth and development of lung function during adolescence and early adulthood. Forced expiratory spirograms and peak expiratory flow rates were obtained in a cohort of normal young men (n = 63) over a period of 4 years, at intervals of approximately 2 years. Two factors that disturbed the normal pattern of lung function development in this group were smoking and respiratory allergy. Among the smokers and the allergics the decline in the forced expiratory volume expressed as a percentage of the forced vital capacity (FEV1%), the forced expiratory flow in the middle half of the forced vital capacity (FEF25-75%) and the FEF25-75% expressed as a ratio of the forced vital capacity (FEF/FVC) was more than double that among the normal subjects. The number of smokers and of allergics increased during the course of the study from 15 to 19 and from 16 to 23 respectively. There was a significant (P less than .01) interaction between smoking and the manifestation of respiratory allergy. Among nonsmokers, the number of allergic subjects increased from 12 to 13, while among smokers it increased from 4 to 10, during the four years.     

Cardiorespiratory responses to submaximal incremental exercise are not affected by one night's sleep deprivation during the follicular and luteal phases of the menstrual cycle

The purpose of the study was to investigate the effects of one night's sleep deprivation on the cardiorespiratory responses to exercise during the follicular and luteal phases of the menstrual cycle. We have studied nine, healthy females aged 24-35 years with regular menstrual cycles. Each subject performed spirometric tests at rest and then an incremental exercise testing during 11-13 days of follicular phase and 22-24 days of luteal phase following one normal night's sleep or one night's sleep loss. Compared with resting values exercise produced significant increases in cardiorespiratory variables including oxygen uptake (VO2), carbon dioxide production (VCO2), tidal volume (VT), respiratory rate (RR), minute ventilation (VE), systolic blood pressure, heart rate (HR) and respiratory quotient (R). However, it did not alter significantly diastolic blood pressure, end-tidal PO2 (PETO2), end-tidal PCO2 (PETCO2) and arterial oxygen saturation (SaO2). Spirometric variables which include forced vital capacity (FVC), forced expiratory volume in one s (FEV1), FEV1/FVC%, forced expiratory volume in three s (FEV3), forced expired flow from 25-75% of FVC (FEF 25-75%), forced expired flow at 25% of FVC (FEF 25%), forced expired flow at 50% of FVC (FEF 50%), forced expired flow at 75% of FVC (FEF 75%), forced expired flow from 75-85% of FVC (FEF 75-85%), peak expiratory flow (PEF), expiratory reserve volume (ERV), inspiratory capacity (IC) and maximal voluntary ventilation (MVV) and cardiorespiratory variables were not different between the cycle phases after one normal night's sleep or one night's sleep deprivation. Neither menstrual cycle phase nor sleep deprivation affected spirometric and cardiorespiratory parameters. We suggest that one night's sleep deprivation does not produce alterations in spirometric parameters and cardiorespiratory responses to submaximal incremental exercise during the follicular and luteal phases.     

联合吸入硫酸镁及沙丁胺醇治疗哮喘的临床研究

目的：探讨联合吸入7.5%等渗硫酸镁及1％沙丁胺醇对发作期哮喘患肺功能的影响。方法：将75例发作期哮喘患随机分成A、B、C3组，每组25人，A组雾化吸入7.5%等渗硫酸镁溶液3ml后间歇5min，再吸入生理盐水3ml。B组雾化吸入0.1%沙丁胺醇3ml后，间歇5min再吸入生理盐水3ml。C组雾化吸入0.1%沙丁胺醇3ml后，间歇5min再雾化吸入7.5%等渗硫酸镁溶液3ml。于吸药前、后15min分界和肺活量（FVC）、1秒钟用力呼气容积（FEV1）、最大呼气流量（PEF）的检测，并分别测A、C两组吸药前后收缩压、舒张压、心率、呼吸的变化。结果：3组吸药前后肺功能指标占其正常预计值的百分比浓度（FVC％、FEV1％、PEF％）比较均有显性差异（P＜0．05）；3组间吸药后15min肺功能比较：B组显高于A组（P＜0．05）；C组非常显高于B组（P＜0．01）和A组（P＜0．01）。A组及C组吸药前后收缩压、舒张率、心率和呼吸频率差异均无显性（P＞0．05）。结论：联合吸入7．5％等渗硫酸镁及1％沙丁胺醇对发作期哮喘患的治疗有协同作用，能明显改善通气功能，且对患的血压、心率、呼吸无明显影响。     

家庭护理理念在小儿哮喘患者中的应用价值

目的 探究家庭护理理念在小儿哮喘患者中的应用价值.方法 选择2014年7月至2015年1月前来我院就诊的78例哮喘患儿为研究对象.抽签随机分为观察组与对照组,每组39例.研究过程中观察组脱落1例.两组住院期间均进行疾病预防与护理基础指导,对照组出院时发放护理手册,观察组出院后在医护人员指导下进行家庭护理.比较两组出院时、出院后6个月第一秒用力呼气容积(FEV1)、第一秒用力呼气容积/用力肺活量百分比(FEV1aVc)及最高呼气流速(PEF),出院后6个月内疾病控制情况,出院时及出院后6个月、1年时的儿童哮喘生活质量调查表(PAQLQ)评分.结果 出院后6个月,观察组FEV1、FEV1/FVC和PEF值分别为(72.48±18.76)L、(83.45±19.76)％、(63.44±17.31)Umin,均明显高于对照组(P＜0.05);观察组出院后6个月内的中重度发病次数、急诊次数分别为(1.15±0.46)次/月、(0.68±0.12)次/月,均显著低于对照组(P＜0.05);观察组出院6个月、1年后的PAQLQ评分分别为(92.67±19.36)、(106.71±19.36),均较对照组明显升高(P＜0.05).结论 对小儿哮喘患者实行家庭护理,可明显改善其肺功能与整体生活质量,有效控制病情,具备推广价值.     

雾化吸入氨溴索联合支气管镜下肺灌洗治疗尘肺的效果观察

目的 观察雾化吸入氨溴索联合支气管镜下肺灌洗治疗尘肺的效果.方法 选择2014年5月至2016年5月本院收治的尘肺病患者92例,按照随机数字表法分为对照组(n=46)和观察组(n=46),对照组采用支气管镜下肺灌洗治疗,观察组采用雾化吸入氨溴索联合支气管镜下肺灌洗治疗,2周后比较监测两组患者治疗前后第一秒用力呼气量(FEV1)、用力肺活量(FVC)以及呼气流量峰值(PEF)水平,临床疗效及不良反应发生情况.结果 观察组患者有效率95.65％显著高于对照组的82.60％ (P＜0.05).两组患者治疗后FEV1、FVC和PEF水平较治疗前均显著上升(P＜0.05),观察组患者治疗后FEV1、FVC和PEF水平均显著高于对照组(P＜0.05).观察组患者不良反应总发生率8.70％与对照组的6.52％差异无统计学意义(P＞0.05).结论 雾化吸入氨溴索联合支气管镜下肺灌洗可以改善尘肺患者肺功能,提高治疗效果.     

Effects of captopril on blood pressure and respiratory function compared to verapamil in patients with hypertension and asthma.

Seventeen adult patients with moderate and stable bronchial asthma and established essential hypertension (WHO I or II) were evaluated in a randomized, double-blind, crossover study of the effects of captopril (50-100 mg/day) and verapamil (160-240 mg/day) on blood pressure, orthostatic reactions, respiratory function, and asthmatic symptoms. The effect of both drugs on blood pressure was significant. Blood pressure (mean of 161/98 mm Hg initially) decreased to a mean of 147/90 and 160/91 mm Hg on captopril and verapamil, respectively, with normal orthostatic changes. There were no significant differences in forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), maximal expiratory flow at 50% of FVC (MEF50), or peak expiratory flow (PEF) measurements at the end of each treatment period. The subjective severity of asthma did not change significantly during the trial. No significant cough symptoms were reported on captopril.     

Effect of oral contraceptives on respiratory function

The present study was carried out to assess the lung functions in oral contraceptive administered women. Lung function tests were carried out with Spirometer (Vitallograph Compact II). A significant increase in vital capacity (VC) was observed in these women as compared to normal control. There was also a significant decrease in forced expiratory volume in 1 sec./vital capacity (FEV1/VC%) and forced expiratory volume in 1 sec./forced vital capacity (FEV1/FVC%) among oral contraceptive administered women as compared to controls. Further, a significant increase in peak expiratory flow rate (PEF), reduction in forced expiratory flow rate (FEF75-85%) and FEF75% were observed among oral contraceptive administered women as compared to controls. The increase in VC and PEF might be due to the synthetic form of progesterone (progestins) present in oral contraceptive pills which causes hyperventilatory changes. Synthetic progesterone during luteal phase of menstrual cycle might increase the static and dynamic volumes of lung i.e. VC and PEF. But FEF75% showed a decrease which might be due to the lower neuromuscular coordination during breathing.     

Spirometric data in South Indian subjects 60-80 years of age

Forced expiratory and inspiratory vital capacities and the timed expiratory and inspiratory volumes and forced expiratory and inspiratory flow rates were determined in 50 old men and women between 60-80 years of age. Some of the ratios between expiratory and inspiratory volumes and flow-rates that have been found to be useful for detecting some forms of ventilatory defects are also given.     

综合康复护理措施在噻托溴铵治疗稳定期COPD患者中的应用

目的:探讨综合康复护理措施在噻托溴铵治疗稳定期慢性阻塞性肺病(COPD)患者中的应用。方法:选取本院2017年1月至2019年2月80例给与噻托溴铵治疗的稳定期COPD患者,随机分为观察组(n=40)和对照组(n=40)。对照组40例患者采用常规护理,观察组40例患者在常规护理基础上使用综合康复护理。比较圣乔治呼吸问卷(SGRQ)评分、呼吸功能指标、患者满意程度。结果:观察组干预后2个月日常活动评分、患者症状评分、疾病影响评分、SGRQ总分低于对照组(P<0.05);观察组干预后2个月第1秒用力呼气容积(FEV1)、FEV1与用力肺活量(FVC)比值(FEV1/FVC)、最大呼吸峰流速(PEF)均高于对照组(P<0.05);观察组满意程度高于对照组(P<0.05)。结论:综合康复护理在噻托溴铵治疗稳定期COPD患者中可以有效缓解患者临床症状、显著改善呼吸功能指标、提高患者满意度。     

小气道功能指标在儿童哮喘病情严重程度评估及临床诊断中的应用

目的 探讨小气道功能指标在儿童哮喘病情严重程度评估及临床诊断中的应用价值。方法 选取2013年5月至2016年4月于郑州市第二人民医院56例哮喘急性发作期病儿作为哮喘组,并根据哮喘急性发作严重程度分为轻度(21例)、中度(20例)和重度(15例)三个亚组,同时选取同期、年龄相仿及性别相匹配的30例因其他原因引起喘息咳嗽的慢性炎症病儿和32例入院检查健康儿童分别作为非哮喘组和对照组,收集各组儿童一般资料,采用肺功能测定系统检测各组儿童用力肺活量(FVC)、最大呼气流量(PEF)、第1秒用力呼气容积(FEV1)和FEV1/FVC比值、呼出25%肺活量时呼气流速(FEF25%)、呼出50%肺活量时呼气流速(FEF50%)、呼出75%肺活量时呼气流速(FEF75%)、最大中期呼气流速(MMEF)等指标。结果 与对照组比较,非哮喘组和哮喘组病儿FVC、FEV1、PEF、FEF25%、FEF50%、FEF75%和MMEF等指标均显著降低(P<0.05),且哮喘组病儿上述指标显著低于非哮喘组[(1.42±0.36)L比(1.85±0.47)L、(1.25±0.32)L比(1.42±0.41)L、(2.68±0.64)L比(3.25±0.77)L/s、(2.54±0.65)L/s比(3.74±0.68)L/s、(1.58±0.36)L/s比(2.24±0.71)L/s、(0.61±0.37)L/s比(1.02±0.41)L/s、(1.42±0.49)L/s比(1.89±0.68)L/s)](均P<0.05),而三组病儿FEV1/FVC指标差异无统计学意义(P>0.05)。哮喘急性发作期不同程度病儿用力呼出25%肺活量的呼气流量占预计值百分比(FEF25pred%)、用力呼出50%肺活量的呼气流量占预计值百分比(FEF50pred%)、用力呼出75%肺活量的呼气流量占预计值百分比(FEF75pred%)、最大呼气中期流量占预计值的百分比(MMEFpred%)等指标比较差异有统计学意义(P<0.05),且随着病情程度增加,病儿FEF25pred%、FEF50pred%、FEF75pred%、MMEFpred%等指标呈现明显降低趋势(P<0.05),FEF25%和FEF75%指标在不同严重程度哮喘病儿中异常率比较,差异有统计学意义(P<0.05),FEF50%和MMEF指标比较差异无统计学意义(P>0.05),其中FEF25%主要表现为轻度异常,而FEF75%主要表现为重度异常。结论 小气道功能指标在儿童哮喘病情严重程度评估及临床诊断具有重要意义,随着病情加剧,小气道功能指标明显降低,且异常率显著增加。     

A study of lung function abnormalities in workers of cotton spinning shops

Lung function was studied by forced expiratory spirograms and measurement of peak expiratory flow in fourteen young male subjects of the age 20 to 30 years. Seven of the subjects were cotton spinners in small shops in Paharganj market with the duration of work from 1 to 3 years. The other seven subjects served as controls. All the subjects were of the same socio-economic status and were North Indians. Forced vital capacity; forced expiratory volume in 1 sec; forced expiratory volume in 1 sec expressed as a percentage of forced vital capacity; forced expiratory flow between 80 and 70 per cent, between 55 and 45 per cent, between 30 and 20 per cent and between 15 and 5 per cent of the forced vital capacity were determined from forced expiratory spirograms. Peak expiratory flow and FEB-80-70% were significantly lower in cotton spinners suggesting involvement of larger airways.     

Function of respiratory system evaluated using selected spirometry parameters in persons occupationally exposed to lead without evident health problems

This study aimed at evaluation of selected spirometric parameters in persons occupationally exposed to lead without evident health problems. The studies were conducted on 69 men occupationally exposed to lead. Occupational exposure to lead was characterized by estimation of blood lead concentration (Pb-B) and blood zinc protoporphyrin concentration (ZnPP). Function of respiratory system was examined using spirometric analysis with evaluation of its basic parameters: forced vital capacity (FVC), forced expiratory volume (in 1 s) (FEV1), Tiffeneau index (FEV1%VC) and peak expiratory flow (PEF). In the study group negative linear correlations were documented between Pb-B and FVC, FEV 1 and FEV1%VC. A more pronounced age, higher values of BMI and higher blood lead concentration constituted independent risk factors for reduced FEV1%VC.ConclusionPersons occupationally exposed to lead with elevated blood lead concentration and blood zinc protoporphyrin concentration manifested the impaired function of respiratory system, evaluated using parameters of spirometry.     

苏葶止喘汤联合西医治疗小儿支气管哮喘急性发作期(痰热阻肺证) 38例

目的探讨苏葶止喘汤联合西医治疗小儿支气管哮喘急性发作期(痰热阻肺证)临床疗效。方法收集 2020年 2月至 2022年 3月河北省沧州中西医结合医院就诊的急性发作期的支气管哮喘病儿 78例,根据随机数字表法分为对照组与治疗组各 39例,对照组病儿给予硫酸沙丁胺醇、异丙托溴铵、布地奈德雾化吸入等西医治疗,治疗组在对照组基础上给予苏葶止喘汤治疗,观察两组治疗前后的临床疗效,症状缓解时间(咳痰消失时间、哮鸣音消失时间、咳嗽消失时间、喘息消失时间)肺功能指标［用力肺活量(FVC)第 1秒用力呼吸容积(FEV1)第 1秒用力呼气量占所有呼气量的比例(FEV1/FVC)最大呼气流量(,PEF)气中断流速( PEF25%)、、呼吸中期瞬间流速( PEF50%、)、呼吸后期瞬间流速( PEF75%)］血清炎症因子指、标［C反应蛋白(CRP)、呼、白细胞介素 -22(IL-22)、白细胞介素 -4(IL-4)］,Toll样受体 2(TLR2)Toll样受体 4(TLR4),表达水平。结果治疗后治疗组总有效率 94.74%显著高于对照组 71.05%(P<0.05);治疗组症状缓解时间快、于对照组( P<0.05);治疗后两组 FVC、FEV1、FEV1/FVC、PEF、PEF25%、PEF50%、PEF75%值均较治疗前升高且治疗组高于对照组( P<0.05);治疗后两组血清 CRP、IL-22、IL-4、TLR2、 TLR4水平均较治疗前降低,且治疗组 CRP［( 10.23±3.26)mg/L比( 15.25±5.37)mg/L］、 IL-22［( 37.13±9.84)ng/L比( 45.46±11.08) ng/L］、IL-4［(48.15±12.28)ng/L比( 56.07±14.36)ng/L］、 TLR2［(16.78±1.91)ng/L比( 21.15±2.08)ng/L］、 TLR4［(18.05±2.53)ng/L比     

Clinical efficacy of two beta 2-sympathicomimetics in different inhalers in children with asthma. Comparison of pirbuterol in a breath-actuated inhaler and salbutamol in a customary metered-dose inhaler.

In a controlled clinical crossover trial, the therapeutic effect of pirbuterol (CAS 38677-81-5) in the Autohaler was compared to that of salbutamol in a customary metered-dose aerosol in 17 children with asthma. Each child was randomized to both treatments with a washout period of at least 1 day and at most 13 days. Ten children commenced with salbutamol and then switched over to pirbuterol, and the other 7 vice versa. The main criterion to evaluate efficacy was the forced expiratory volume after 1 s (FEV1). Other efficacy criteria were forced vital capacity (FVC) and peak expiratory flow (PEF). The patients were given detailed instructions on how to use the inhalers. Each treatment was applied in the morning with one shot (0.2 mg pirbuterol or 0.1 mg salbutamol). FEV1, FVC and PEF were measured in all patients 10 min before and 10 min after medication with the whole-body plethysmograph; further measurements were carried out in most patients 60 and 240 min after application. There was a mean increase of 47% in the FEV1 compared to baseline with pirbuterol in the Autohaler compared to a mean increase of only 30% with salbutamol in the customary metered-dose inhaler. The difference is statistically significant (p = 0.036). A linear crossover analysis showed a significant treatment effect 10 min after application in favour of pirbuterol with no significant period effects or interactions (p = 0.020). The increases of FVC and PEF after pirbuterol treatment were also remarkably higher than after salbutamol. No side effects were observed.     

The effect of tiotropium on the pulmonary diffusing capacity

To our knowledge, there is no data on the effect of tiotropium on pulmonary gas exchange in healthy subjects. The aim of this study was to assess the effects of tiotropium on pulmonary diffusing capacity. Twenty-one healthy volunteers were enrolled for a prospective, randomized, double-blind, placebo-controlled study. Spirometric measurements, including pulmonary-diffusing capacity, were obtained before and after inhalation of drug or placebo. There was a significant decrease in forced vital capacity (FVC) and, consequently, an increase in the forced expiratory volume in one second (FEV1) to FVC ratio after placebo inhalation (p < 0.05), but no changes were found for percent-predicted FVC, FEV1, percent-predicted FEV1, percent-predicted forced expiratory flow (FEF25%-75%), percent-predicted peak expiratory flow (PEF), diffusing capacity of the lung for carbon monoxide (DLCO), single-breath alveolar volume (VA) and DLCO/VA ratio when compared with the baseline. Tiotropium inhalation caused a significant increase in FVC, percent-predicted FEV1, FEV1/FVC and percent-predicted FEF25%-75%, although the decrease in DLCO was insignificant (12.4 +/- 0.9 to 11.4 +/- 0.9). In conclusion, tiotropium does not change the pulmonary-diffusing capacity in healthy volunteers.     

Gender differences in the use of peak flow meters and their effect on peak expiratory flow

STUDY OBJECTIVE: To determine if gender differences in the skill of using peak flow meters affect peak expiratory flow (PEF). DESIGN: Prospective observational study. SETTING: University classroom. SUBJECTS: One hundred sixteen first-year pharmacy students (76 women, 40 men). INTERVENTION: Students were taught correct use of a peak flow meter by means of classroom discussion and demonstrations. MEASUREMENTS AND MAIN RESULTS: The students' technique in use of the peak flow meter was scored 3 times, and their PEF was recorded. Men scored higher than women (p=0.03) for the steps of "inhale fully" and "exhale as hard and as fast as you can" in the first attempt. Percentage increases in PEF did not significantly differ between the groups. Percentage change in PEF improved from the second attempt to the third attempt in women (p=0.036) but not men. On the third attempt, 13.2% of women versus 2.6% of men had an increase in PEF of more than 50% (p=0.1). CONCLUSION: This study found that men learned the correct technique for using a peak flow meter and attained their best PEF more quickly than women.     

孟鲁斯特联合布地奈德治疗咳嗽变异性哮喘的疗效及对肺功能的影响

目的 探讨孟鲁斯特联合布地奈德治疗咳嗽变异性哮喘（CVA）患儿的临床疗效及对肺功能的影响。方法 选取2014年3月-2017年3月渭南市第一医院收治的CVA患儿280例,按照治疗方式分为对照组和观察组,各140例。对照组在常规治疗的基础上给予患儿布地奈德治疗,观察组在对照组的基础上给予孟鲁斯特治疗,两组均治疗60 d。比较两组的临床疗效,治疗前后肺功能指标呼气流量峰值（PEF）、1s用力呼吸容积（FEV1）及一秒率（FEV1/FVC）,比较两组不良反应的发生情况。结果 治疗后,观察组临床疗效的总有效率是94.29%,显著高于对照组的77.14%,差异有统计学意义（P<0.05）。两组患儿治疗前的肺功能指标比较无明显差异,两组治疗后以上检测指标较治疗前均显著提高,同组治疗前后比较差异有统计学意义（P<0.05）;治疗后,观察组PEF、FEV1、FEV1/FVC水平均显著高于对照组,差异有统计学意义（P<0.05）。两组患儿在治疗期间均无严重不良反应的发生,不良反应发生情况无显著差异。结论 孟鲁斯特联合布地奈德治疗咳嗽变异性哮喘比单用布地奈德治疗的临床效果好,可有效改善患儿的肺功能,值得临床推广。     

沙美特罗/丙酸氟替卡松对哮喘儿童肺功能的改善及临床意义

目的:观察沙美特罗/丙酸氟替卡松对哮喘儿童肺功能改善情况。方法:采用德国Jaeger公司的MasterscreenIOS测定仪,对61例支气管哮喘患儿在沙美特罗/丙酸氟替卡松治疗前后进行通气肺功能(F-V)和脉冲振荡(IOS)检测。观察用力肺活量(FVC)、第一秒用力呼气容积(FEV1)、最大呼气流速(PEF)、呼出25%肺活量时最大呼气流量(FEF25)、呼出50%肺活量时最大呼气流量(FEF50)、呼出75%肺活量时最大呼气流量(FEF75);呼吸阻抗(Zrs)、气道总阻力(R5)、中心气道阻力(R20)、响应频率(Fres)。结果:沙美特罗/丙酸氟替卡松治疗后FVC、FEV1、PEF均明显升高(P<0.001),而Zrs、R5、R20、Fres均明显降低(P<0.05),两者检查结果均有显著统计学意义。结论:吸入沙美特罗/丙酸氟替卡松能改善哮喘儿童的肺通气功能,降低气道阻力,是治疗儿童哮喘的理想药物之一。     

布地奈德结合异丙托溴铵治疗慢性阻塞性肺疾病临床研究

目的观察并分析布地奈德结合异丙托溴铵治疗慢性阻塞性肺疾病的临床效果。方法140例慢性阻塞性肺疾病患者为研究对象,随机分为观察组与对照组,每组70例。对照组患者给予复方异丙托溴铵治疗,观察组患者给予布地奈德结合异丙托溴铵治疗。对比两组患者临床疗效、治疗前后肺功能指标[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、呼气流速峰值(PEF)、最大呼气中期流速(MMEF)]、不良反应发生情况。结果观察组总有效率94.29%显著高于对照组的77.14%,差异具有统计学意义(P<0.05)。治疗后,两组患者FEV1、FVC、PEF、MMEF水平均高于本组治疗前,且观察组高于对照组,差异均具有统计学意义(P<0.05)。观察组不良反应发生率10.00%与对照组的11.43%对比,差异无统计学意义(P>0.05)。结论布地奈德结合异丙托溴铵治疗慢性阻塞性肺疾病疗效较好,可以显著改善临床症状,有利于肺功能的恢复。     

腋下小切口对慢性阻塞性肺疾病自发性气胸患者呼吸功能的影响

目的探讨腋下小切口对COPD自发性气胸患者呼吸功能的影响。方法98例COPD自发性气胸患者按照数字表法随机分为两组,观察组49例,对照组49例。观察组采用腋下小切口手术治疗,对照组采用传统手术治疗。测定两组患者FEV1.用力呼气肺活量（FVC）、呼气峰流量（PEF）的变化。结果所有患者手术经过顺利,无手术死亡,术后均无漏气,患者复查胸部X线或胸部cT片显示患侧肺全部复张。观察组手术时间、术中出血量、切口长度均小于对照组（t=2．726、3．725、6．927,P〈0．05或P〈0．01）。两组治疗前FEV1、FVC、PEF差异均无统计学意义（t=0．925、0．461、0．628,均P〉0．05）;治疗后两组FEV1、FVC、PEF均有明显改善,并且观察组优于对照组（t=2．765、2．197、3．298,均P〈0．05）。结论腋下小切口手术可以更明显改善COPD自发性气胸患者的呼吸功能。