慢性阻塞性肺疾病急性加重期患者规范化痰诱导安全性的初步研究

目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者进行高渗盐水痰诱导的安全性。方法制定规范化操作流程,对22例重度、极重度AECOPD患者进行痰诱导,在诱导过程中严密监测患者第一秒用力呼气容积(FEV1)和脉搏容积血氧饱和度(SpO2)的变化。结果22例AECOPD患者在诱导前SpO2为(93.8±0.9)%,结束时SpO2为(91.7±0.8)%,较基础值下降了(2.1±0.4)%(P<0.01),结束后10min,SpO2恢复至基础值水平;诱导前FEV1为(0.70±0.19)L,结束时为(0.62±0.17)L,FEV1较基础值下降了(12.3±3.1)%(P=0.027),结束后10min,FEV1恢复至基础值水平。共有19例患者渡过了整个痰诱导过程,成功率为86%。结论在严密监控下,使用规范化的痰诱导流程,痰诱导法对AECOPD患者是一种比较安全的方法。

Safety of sputum induction in subjects with acute exacerbations of chronic obstructive pulmonary disease

OBJECTIVE: To evaluate the safety of sputum induction in subjects with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). METHODS: Twenty-two patients with AECOPD were enrolled in the study. All subjects inhaled a mist of 3% hypertonic saline solution and the forced expiratory volume in one second (FEV(1)) and pulse oxygen saturation (SpO(2)) were measured during the procedure. RESULTS: A significant fall in SpO(2) and FEV(1) was found during sputum induction by inhalation of 3% hypertonic saline solution. Mean decline in SpO(2) during sputum induction was (2.1 +/- 0.4)% (P < 0.01) and recovered within 10 min after cessation of sputum induction. Mean decline in FEV(1) during sputum induction was (12.3 +/- 3.1)% (P = 0.027), an absolute fall of (0.11 +/- 0.03) L, and the FEV(1) returned to the baseline in all subjects within 10 min after cessation of sputum induction. The sputum induction was successful in 19 of the 22 (86%) patients. CONCLUSION: The use of a standardized sputum induction protocol is relatively safe in sampling the lower airways in patients with AECOPD.