不同浓度碳酸氢钠雾化对COPD患者疗效及真菌感染发生情况分析

目的 探讨吸入不同浓度的碳酸氢钠溶液雾化治疗对慢性阻塞性肺疾病（COPD）患者的疗效及真菌感染发生情况。方法 选取2017年1月~2018年12月我院呼吸内科收治的COPD患者72例作为研究对象，采用随机数字表法分为A、B、C三组，每组24例。其中A组吸入碳酸氢钠溶液浓度为1.5%，B组吸入浓度为2.5%，C组吸入浓度为5.0%，比较各组患者治疗后第2、4、6 天的24 h排痰量及治疗1周后肺部啰音消失时间、体温恢复正常时间、血常规恢复正常时间、住院天数、肺功能改善情况及治疗前后真菌感染情况。结果 B组患者第4天24 h排痰量多于A组和C组，差异具有统计学意义（P＜0.05）；治疗1周后，B组肺部啰音消失时间、体温恢复正常时间、血常规恢复正常时间、住院天数较A组和C组低，差异具有统计学意义（P＜0.05），而A组和C组比较，差异无统计学意义（P＞0.05）；各组肺功能指标较治疗前有改善，其中B组指标优于A组和C组，差异有统计学意义（P＜0.05）；B组患者口腔真菌感染的发生率为0 ，低于A组（12.50%）和C组（16.67%），差异具有统计学意义（P＜0.05）。结论 COPD患者采用雾化碳酸氢钠吸入有助于提高排痰效果，改善肺功能，缩短患者住院时间，降低口腔真菌感染率，且浓度为2.5%的效果更优，适合在临床应用。

Analysis of the Effect of Different Concentrations of Sodium Bicarbonate Atomization on Patients with COPD and the Occurrence of Fungal Infections

Objective To investigate the effect of inhalation of sodium bicarbonate solution with different concentrations on patients with chronic obstructive pulmonary disease (COPD) and the occurrence of fungal infection. Methods 72 COPD patients admitted to our department of respiratory medicine from January 2017 to December 2018 were selected as the research subjects. They were divided into three groups of A, B and C by random number table method, with 24 cases in each group. The concentration of inhaled sodium bicarbonate solution in group A was 1.5%, the inhaled concentration in group B was 2.5%, and the inhaled concentration in group C was 5.0%. The 24 h sputum output and treatment of patients in each group were compared on day 2, 4, and 6 after treatment. Pulmonary rales disappeared time, body temperature returned to normal time, blood routine returned to normal time, length of hospital stay, lung function improvement and fungal infection before and after treatment.Results Patients in group B had more sputum excretion at 24 h on day 4 than those in groups A and C,the difference was statistically significant (P<0.05);After 1 week of treatment, the time of disappearance of lung rales in group B, time to return to normal body temperature, time to return to normal blood routine, and length of hospital stay were lower than those in groups A and C,the differences were statistically significant (P<0.05);The difference between group A and group C was not statistically significant (P>0.05); the lung function indicators of each group were improved compared with before treatment, and the indicators of group B were better than those of group A and group C,the difference was statistically significant (P<0.05); the incidence of oral fungal infections in group B patients was 0, which was lower than those in group A (12.50%) and group C (16.67%),the difference was statistically significant (P<0.05).Conclusion Inhalation of aerosolized sodium bicarbonate in COPD patients can help improve sputum excretion, improve lung function, shorten the length of hospital stay, and reduce oral fungal infection. The concentration of 2.5% is more effective and suitable for clinical application.