慢性阻塞性肺疾病合并肺间质纤维化的临床诊断要点分析

目的探讨慢性阻塞性肺疾病合并肺间质纤维化的临床诊断要点。方法选择慢性阻塞性肺疾病合并肺间质纤维化患者50例为观察组,并选择同期收治的慢性阻塞性肺疾病患者50例为对照组,比较两组患者的临床体征、吸烟比例及吸烟史,肺功能检查中的肺功能1 s用力呼气比、用力呼气容积。结果观察组Velcro啰音、杵状指和桶状胸发生率低于对照组（P〈0.05）,叩诊清音发生率高于对照组（P〈0.05）,吸烟比例高于对照组（P〈0.05）,吸烟史时间长于对照组（P〈0.05）,1 s用力呼气比低于对照组（P〈0.05）,用力呼气容积低于对照组（P〈0.05）。结论对于长期吸烟的慢性阻塞性肺疾病患者,听诊出现双肩胛下广泛Velcro啰音,并伴有杵状指和桶状胸者,应提高对其发生肺间质纤维化改变的重视。

Clinical diagnostic criteria of chronic obstructive pulmonary disease combined with pulmonary fibrosis

Objective To investigate the clinical diagnostic criteria of chronic obstructive pulmonary disease combined with pulmonary fibrosis. Methods 50 cases of patients with chronic obstructive pulmonary disease combined with pulmonary fibrosis were as observation group,and 50 cases of patients with chronic obstructive pulmonary disease were as control group,the clinical signs,proportion of smokers and smoking history,and pulmonary function tests of lung function in one second forced expiratory ratio,forced expiratory volume of the two groups were compared. Results The observation group with Velcro rales,clubbing and barrel chest ratio were lower than those of control group（P〈0.05）,percussion voiceless was higher than that of control group（P〈0.05）,smoking rate was higher than that of control group（P〈0.05）,smoking history was longer than that of control group（P〈0.05）,second forced expiratory ratio was higher than that of control group（P〈0.05）,forced expiratory volume was lower than that of the control group（P〈0.05）. Conclusion For patients with chronic obstructive pulmonary disease with long-term smoking,if double-subscapularis widely with Velcro rales with auscultation and clubbing and barrel chest,should improve its occurrence of pulmonary interstitial fibrosis attention.