急性加重期慢性阻塞性肺疾病286例临床分析

目的：探讨慢性阻塞性肺疾病（ COPD）急性加重的易患因素、临床特点及预后。方法：对286例COPD急性加重患者针对发病原因及诊治情况进行分析。结果：226例患者由于呼吸道感染诱发,理化因素是发病的主要因素,其他如情绪应激、电解质紊乱、失眠、停药、自发性气胸、肺栓塞也可以导致加重,C反应蛋白、中性粒细胞升高明显,278例患者1 s用力呼气容积出现下降,合并多器官疾病、多重耐药菌感染、反复机械通气史、低蛋白血症等导致病死的风险大。结论：呼吸道感染和理化因素是COPD急性加重的主要原因,临床表现及实验室检查表现不均一,合并多种复杂状况则病死率高,应该高度重视。

Clinical analysis of acute exacerbation of chronic obstructive pulmonary disease in 286 cases

Objective：To investigate the risk factors, clinical features and prognosis of acute exacerbation of chronic obstructive pulmonary disease（ COPD） . Methods：The etiology and treatment of 286 patients with COPD were retrospectively analyzed. Results：Among 226 patients,the respiratory infection and physical and chemical factors were the inducing factor and main factors of disease, respectively. The emotional stress,electrolyte disorder,insomnia,drug withdrawal,spontaneous pneumothorax and pulmonary embolism could aggravate the diseases,and the levels of C-reactive protein and neutrophil increased obviously in 226 patients. The FEV1. 0 in 278 patients decreased. The risk of death in patients with multiple organ disease, multiple drug-resistant bacteria infection, repeated mechanical ventilation and hypoalbuminemia was large. Conclusions：Respiratory infection and physical and chemical factors are the main causes of the acute exacerbation of COPD. Clinical manifestations and laboratory examination results are inconsistent,the fatality rate of patients with complex conditions is high,which should be greatly paid attention to.