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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
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| 篇名： | 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 |
| TITLE： | |
| 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18 μg，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（P＜0.05）。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（P＞0.05）；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（P＜0.05）。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（P＜0.05）。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 with bronchoalveolar lavage （BAL） on short-term efficacy， quality of life and re-hospitalization rate of patients with bronchiectasis complicated with lung infection. METHODS： A total of 140 patients with bronchiectasis complicated with lung infection selected from our hospital during Oct. 2013-Dec. 2015 were divided into control group and observation group by lottery， with 70 cases in each group. Based on intervention therapy， control group received BAL. Observation group was additionally given Tiotropium bromide powder inhalation 18 μg ， once a day before going to bed， on the basis of control group. Both groups were treated for 4 weeks. Clinical efficacy was compared between 2 group； pulmonary ventilation function indexes， blood gas analysis indexes，BODE index scores and QLI scores before and after treatment， re-hospitalization rate and the occurrence of ADR were also compared between 2 groups. RESULTS： The total response rate of observation group was 91.43％， which was significantly higher than that of control group （78.57％）， with statistical significance （P＜0.05）. Before treatment， there was no statistical significance in pulmonary ventilation function indexes，blood gas analysis indexes，BOED index scores or QLI scores between 2 groups （P＞0.05）. After treatment， FVC， FEV1， FEV1％， p（O2） and QLI score of 2 groups were increased significantly， while p（CO2） and BODE index scores were decreased significantly， compared to before treatment； all indexes of the observation group was significantly better than the control group， with statistical significance （P＜0.05）. The re-hospitalization rate of observation group 3， 6 months after treatment was significantly lower than that of control group， with statistical significance（P＜0.05）. No ADR was found in 2 groups. CONCLUSIONS： For patients with bronchiectasis complicated with lung infection， tiotropium bromide assisted with BAL can effectively relieve the clinical symptoms and signs， improve lung ventilation function and the quality of daily life and can be helpful to reduce the risk of re-hospitalization with good safety. |
| 期刊： | 2017年第28卷第20期 |
| 作者： | 黄有环，王瑞光，李志良 |
| AUTHORS： | HUANG Youhuan，WANG Ruiguang，LI Zhiliang |
| 关键字： | 噻托溴铵；支气管肺泡灌洗；支气管扩张；肺部感染；肺功能；生活质量；再住院率 |
| KEYWORDS： | Tiotropium bromide； Bronchoalveolar lavage； Bronchiectasis； Lung infection； Lung function； Quality of life； Re-hospitalization rate |
| 阅读数： | 265 次 |
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