噻托溴铵与沙美特罗/氟替卡松联合治疗慢性阻塞性肺疾病的临床疗效及院内感染情况分析

目的研究噻托溴铵与沙美特罗/氟替卡松联合治疗慢性阻塞性肺疾病(COPD)患者的临床疗效。方法将我院收治的64例符合研究标准的COPD患者随机分为单药组和联合组,每组各32例。单药组仅给予沙美特罗/氟替卡松干粉剂,联合组同时给予噻托溴铵及沙美特罗/氟替卡松干粉剂。比较两组患者在治疗前和治疗后3个月、6个月、12个月的肺功能变化情况,并进行两组患者院内感染情况分析。结果两组患者治疗后各时期肺功能指标均较治疗前明显改善(P<0.05),且联合用药组改善效果更明显(P<0.05);单药组发生院内感染5例,联合组2例,感染均以革兰阴性杆菌为主。结论采用噻托溴铵与沙美特罗/氟替卡松联合用药治疗COPD的效果较单纯用药效果好,能显著改善患者的肺功能状况,减少院内感染情况的发生。

Efficacy of Tiotropium combined with Salmeterol/Fluticasone in the treatment of chronic obstructive pulmonary disease and analysis of nosocomial infection

Objective To investigate the clinical efficacy of Tiotropium combined with Salmeterol/Flutica-sone in the treatment of chronic obstructive pulmonary disease （COPD）. Methods Sixty-four hospitalized COPD patients who met the study inclusive criteria were randomly allocated to a monotherapy group （n =32） and a combination group （n =32）.The monotherapy group only received Salmeterol/Fluticasone propionate dry powder,while the combined group was given Tiotropium combined with Salmeterol /Fluticasone propio-nate dry powder.Lung function changes were compared between the two groups before treatment and 3 months,6 months,12 months after treatment,and the nosocomial infection of the two groups were investiga-ted. Results Compared to pre-treatment,the pulmonary function parameters were significantly improved in each post-treatment period in the two groups （P〈0.05）,and the combined group got better responders （P〈 0.05）;five cases of nosocomial infections occurred in the monotherapy group and two occurred in the combination group,and Gram-negative bacilli was the main bacilli. Conclusion In treatment of COPD,the combination of Tiotropium and Salmeterol /Fluticasone is more effective than salmeterol /fluticasone alone, which can improve lung function and reduce the incidence of nosocomial infection.