评判性思维在沙美特罗联合丙酸氟替卡松治疗老年重度慢性阻塞性肺疾病患者疗效分析中的应用

目的运用评判性思维,分析老年重度慢性阻塞性肺疾病（COPD）患者在吸入沙美特罗联合丙酸氟替卡松后其肺功能的变化情况。方法以评判性思维为指导,随机将我院2009年1月～2011年9月住院治疗的80例老年重度COPD患者分为沙美特罗组（对照组∕A组）和沙美特罗联合丙酸氟替卡松组（实验组∕B组）,A、B均给予常规吸氧、抗感染、化痰、平喘等常规条件下的对症治疗。A、B组入院治疗、出院后继续使用各自治疗方案并随访观察24周。A、B组均于治疗前及出院24周检查肺功能及血气分析等。结果治疗前A、B组的第1s用力呼气容积（FEV1）、用力肺活量（FVC）、FEV1/FVC、FEV1占预计值百分比（FEV1%）、PaO2、PaCO2等的差异均无统计意义（P〉0.05）;治疗后B组较A组症状有明显改善（P〈0.05）。结论在分析评价的基础上,发现B组疗法对老年人重度COPD患者肺功能有显著作用,可以更好地促进患者康复。

Application of critical thinking in analysis of effect of salmeterol and fluticasone propionate on elderly patients with severe chronic obstructive pulmonary disease

Objective Using critical thinking,to analysis the changes of the lung function in the old patients with severe chronic obstructive pulmonary disease (COPD) after treatment with salmeterol and fluticasone propionate. Methods Using critical thinking as the instruction,80 cases of severe COPD old patients were randomly divided into salmeterol group(control group/A group),salmeterol and fluticasone propionate group(experiment group/B group),they all received conventional oxygen,anti-infection,eliminating phlegm to smooth wheezing,their treatment plan continue to use and follow-up 24 weeks after discharge,and lung function and blood gas were analyzed. Results Forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC),FEV1/FVC of expected value,FEV1 percentage (FEV1 %),PaO2,PaCO2 differences were no statistical significance (P>0.05) in patients before treatment ; symptoms of B group was obviously improved than A group after treatment(P<0.05). Conclusion On the basis of analysis and evaluation,it is found that the treatment has a significant effect on lung function of the elder patients in B group with severe COPD,These promotes patients rehabilitation effectively.