沙丁胺醇联合异丙托溴铵对AECOPD的疗效观察

目的 探究沙丁胺醇联合异丙托溴铵治疗慢性阻塞性肺疾病急性加重期（acute exacerbation of chronic obstructive pulmonary disease,AECOPD）效果。方法 选取2019年10月至2021年12月浙江医疗健康集团衢州医院收治的AECOPD患者168例,采用随机数字表法分为对照组（n=84）和研究组（n=84）。对照组给予硫酸沙丁胺醇气雾剂吸入治疗,研究组在对照组的基础上加用异丙托溴铵雾化吸入治疗。比较两组临床症状、肺功能、血气分析及不良反应。结果 研究组患者的胸闷缓解时间、气急缓解时间、哮鸣音缓解时间、咳嗽缓解时间均显著低于对照组（P<0.05）;治疗后研究组第1秒用力呼气容积（forced expiratory volume in first second,FEV1）、第1秒用力呼气容积占预计值的百分比（FEV1 predicted,FEV1%）、FEV1/用力肺活量（forced vital capacity,FVC）显著高于对照组（P<0.05）;治疗后,两组的动脉血氧分压（partial pressure of oxygen,PaO2）水平升高,动脉血二氧化碳分压（partial pressure of carbon dioxide,PaCO2）水平降低,差异均有统计学意义（P<0.05）;研究组PaO2显著高于对照组（P<0.05）,PaCO2显著低于对照组（P<0.05）。两组的不良反应发生率比较,差异无统计学意义（P＞0.05）。结论 异丙托溴铵联合沙丁胺醇对AECOPD的治疗效果显著优于异丙托溴铵单独治疗,可较好改善临床症状,提高肺功能,临床应用安全,值得临床普及应用。

Efficacy observation of salbutamol combined with ipratropium bromide in the treatment of AECOPD

Objective To explore the effect of albuterol combined with ipratropium bromide in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods A total of 168 patients with AECOPD admitted to Zhejiang Medical & Health Group Quzhou Hospital from October 2019 to December 2021 were selected and divided into the control group (n=84) and the study group (n=84) according to random number table method. the control group was treated with salbutamol sulfate aerosol, and the study group was treated with ipratropium bromide aerosol inhalation on top of the control group. The clinical symptoms, pulmonary function, blood gas analysis and adverse reactions were compared between the two groups. Results The chest tightness relief time, shortness of breath relief time, wheezing relief time, cough relief time in the study group were significantly lower than those in the control group (P<0.05). After treatment, the forced expiratory volume in first second(FEV1), FEV1 predicted (FEV1%) and FEV1/forced vital capacity (FVC) of the study group were significantly higher than those of the control group (P<0.05). After treatment, pressure of carbon dioxide(PaCO2) levels decreased and partial pressure of oxygen(PaO2) levels increased in both groups, and the differences were statistically significant (P<0.05);and PaO2 in the study group was significantly higher than that in the control group (P<0.05), while PaCO2 was significantly lower than that in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the control group and the study group (P>0.05). Conclusion The efficacy of ipratropium bromide combined with salbutamol in the adjuvant treatment of AECOPD is significantly better than that of ipratropium bromide alone, which can better improve clinical symptoms and lung function. It is safe and worthy of promotion.