噻托溴铵辅助支气管肺泡灌洗用于支气管扩张合并肺部感染的临床观察

发布时间：2018-10-08 17:11

【摘要】：目的:探讨噻托溴铵辅助支气管肺泡灌洗(BAL)对支气管扩张合并肺部感染患者近期疗效、生活质量及再住院率的影响。方法:选取我院2013年10月-2015年12月收治的支气管扩张合并肺部感染患者140例,按抽签法分为对照组和观察组,各70例。在对症干预治疗基础上,对照组患者给予BAL治疗;观察组患者在对照组基础上加用噻托溴铵粉吸入剂18μg,每天睡前吸入1次。两组患者均治疗4周。比较两组患者的临床疗效,治疗前后肺通气功能指标和血气分析指标水平、BODE指数评分和生活质量指数量表(QLI)评分,以及再住院率和不良反应发生情况。结果:观察组患者的总有效率为91.43%,显著高于对照组的78.57%,差异有统计学意义(P0.05)。治疗前,两组患者的肺通气功能指标和血气分析指标水平、BODE指数评分和QLI评分比较,差异均无统计学意义(P0.05);治疗后,两组患者的用力肺活量、一秒用力呼气容积(FEV1)、FEV1占预计值百分比、氧分压、QLI评分均较治疗前显著升高,二氧化碳分压、BODE指数评分均较治疗前显著降低,且观察组各指标均显著优于对照组,差异均有统计学意义(P0.05)。观察组患者治疗后3、6个月的再住院率均显著低于同期对照组,差异有统计学意义(P0.05)。两组患者均未见明显不良反应发生。结论:噻托溴铵辅助BAL用于支气管扩张合并肺部感染可有效缓解患者的症状体征,提高肺通气功能,改善日常生活质量,有助于降低再住院风险,且安全性高。
[Abstract]:Objective: to investigate the effects of tiotropium bromide assisted bronchoalveolar lavage (BAL) on the short-term efficacy, quality of life and readmission rate of bronchiectasis complicated with pulmonary infection. Methods: 140 cases of bronchiectasis complicated with pulmonary infection from October 2013 to December 2015 were selected and divided into control group and observation group by drawing lots. On the basis of symptomatic intervention, the patients in the control group were treated with BAL, and the patients in the observation group were treated with 18 渭 g tiotropium bromide powder inhaled once a day before bedtime. Both groups were treated for 4 weeks. The clinical efficacy, pulmonary ventilation function and blood gas analysis were compared between the two groups before and after treatment. Bode index score and quality of life index scale (QLI) score, rehospitalization rate and adverse reactions were compared between the two groups. Results: the total effective rate of the observation group was 91.43 significantly higher than that of the control group 78.57 (P0.05). Before treatment, there was no significant difference in pulmonary ventilation function index and blood gas analysis index, bode index score and QLI score between the two groups (P0.05); after treatment, the forced vital capacity of the two groups was higher than that of the control group. Forced expiratory volume of one second (FEV1) and FEV1 as a percentage of predicted value, oxygen partial pressure and QLI scores were significantly higher than those before treatment, and the scores of carbon dioxide partial pressure and bode index were significantly lower than those before treatment, and each index of the observation group was significantly better than that of the control group. The difference was statistically significant (P0.05). The rehospitalization rate of the patients in the observation group was significantly lower than that in the control group at 3 and 6 months after treatment, and the difference was statistically significant (P0.05). No significant adverse reactions occurred in both groups. Conclusion: tiotropium bromide combined with BAL can effectively relieve the symptoms and signs of bronchiectasis with pulmonary infection, improve pulmonary ventilation function, improve the quality of daily life, reduce the risk of re-hospitalization, and have high safety.
【作者单位】：解放军第187中心医院呼吸内科;
【分类号】：R562.22;R563.1

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