布地奈德联合复方异丙托溴铵雾化吸入治疗围术期尘肺病的临床研究

摘要
图/表
参考文献(20)
相关文章 (15)

全文: PDF (590 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨布地奈德联合复方异丙托溴铵雾化吸入治疗围术期尘肺病的临床效果。方法选择广州医科大学附属广州第十二人民医院2014年1月～2017年2月收治的139例尘肺病患者，按随机数字表法将其分为对照组（69例）和治疗组（70例）。两组患者均于全身静脉复合麻醉后给予大容量全肺灌洗（WLL）治疗，治疗组在术前3 d到术后3 d期间在WLL基础上均给予布地奈德联合复方异丙托溴铵雾化吸入治疗。比较两组治疗前3 d和治疗后7 d的临床症状综合评分、肺功能指标和血气指标、痰液中肿瘤坏死因子-α（TNF-α）、白介素-1（IL-1）水平，记录并比较两组患者治疗过程中不良反应的发生情况。结果两组治疗后临床症状综合评分明显低于治疗前，用力肺活量（FVC）、第1秒用力呼气容积（FEV1）均明显大于治疗前，且治疗组治疗后临床症状综合评分、FVC、FEV1变化明显优于对照组，差异均有统计学意义（P ＜ 0.05）。两组治疗后血氧分压（PaO2）明显大于治疗前，动脉血二氧化碳分压（PaCO2）明显小于治疗前，且治疗组治疗后PaO2、PaCO2变化明显优于对照组，差异均有统计学意义（P ＜ 0.05）。两组治疗后痰液中TNF-α、IL-1水平均明显低于治疗前，且治疗组治疗后痰液中TNF-α、IL-1水平均明显低于对照组，差异均有统计学意义（P ＜ 0.05）。治疗过程中，治疗组低氧血症、气道痉挛、气道压增高等不良反应的发生率均明显低于对照组，差异均有统计学意义（P ＜ 0.05）。结论布地奈德联合复方异丙托溴铵雾化吸入辅助治疗给予WLL的尘肺病患者，能够提高WLL的疗效，缓解临床症状，改善患者肺功能和PaO2，降低痰液中炎症因子水平，减轻不良反应的发生，值得在临床上推广应用。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	麦子健1 袁丽玲2 赵健3

关键词 ：布地奈德, 复方异丙托溴铵, 大容量全肺灌洗, 尘肺病, 疗效

Abstract：Objective To investigate the effects of aerosol inhalation of Budesonide combined with Compound Ipratropium Bromide in the treatment of patients with perioperative pneumoconiosis. Methods One hundred and thirty-nine patients with pneumoconiosis admitted to Guangzhou Twelfth People's Hospital Affiliated to Guangzhou Medical University from January 2014 to February 2017 were enrolled in this study, and they were divided into control group (69 cases) and treatment group (70 cases) by random number table method. Both groups were treated by whole-lung lavage (WLL) under general anesthesia. The treatment group was treated with aerosol inhalation of Budesnide combined with Compound Ipratropium Bromide during the period of 3 days before treatment and 3 days after treatment. The comprehensive score of clinical symptoms, lung function index, blood gas index and the sputum tumor necrosis factor -α (TNF-α), interleukin-1 (IL-1) levels of the two groups during the period of 3 days before treatment and 7 days after treatment were compared between the two groups. The adverse reactions during the treatment of the two groups were recorded. Results The comprehensive score of clinical symptoms of the two groups after treatment were significantly lower than those before treatment, the forced vital capacity (FVC), forced expiratory volume in one second (FEV1) of the two groups after treatment were significantly higher than those before treatment, and the improvement of comprehensive score of clinical symptoms, FVC, FEV1 in the treatment group was significantly better than those of the control group (P ＜ 0.05). The partial pressure of blood oxygen (PaO2) of the two groups after treatment were significantly higher than those before treatment, the arterial partial pressure of carbon dioxide (PaCO2) of the two groups after treatment were significantly lower than those before treatment, and the changes of PaO2, PaCO2 after treatment in the treatment group were significantly better than those of control group, the differences were statistically significant (P ＜ 0.05). The levels of sputum TNF-α, IL-1 in the two groups after treatment were significantly lower than those before treatment, and the levels of sputum TNF-α, IL-1 after treatment in the treatment group were significantly lower than those of the control group (P ＜ 0.05). The incidence of adverse reactions of hyoxemia, airway spasm, airway pressure increasing of the treatment group was significantly lower than that of the control group during the treatment, the difference was statistically significant (P ＜ 0.05). Conclusion Aerosol inhalation of Budesonide combined with Compound Ipratropium Bromide in the treatment of patients with pneumoconiosis who were given WLL can improve clinical efficacy of WLL, relieve clinical symptoms, improve pulmonary function and SpO2, decrease the levels of sputum inflammatory factors and reduce the occurrence of adverse reactions, and it is worthy of clinical promotion and application.

Key words： Budesonide Compound Ipratropium Bromide Whole-lung lavage Pneumoconiosis Efficacy

基金资助:广东省广州市医药卫生科技一般引导项目（20151A011095）。

通讯作者: 赵健（1963.7-），男，博士，主任医师，硕士生导师；研究方向：肺癌综合治疗。

引用本文:

麦子健1 袁丽玲2 赵健3. 布地奈德联合复方异丙托溴铵雾化吸入治疗围术期尘肺病的临床研究[J]. 中国医药导报, 2018, 15(14): 97-101.
MAI Zijian1 YUAN Liling2 ZHAO Jian3. Clinical research of aerosol inhalation of Budesnide combined with Compound Ipratropium Bromide in the treatment of patients with perioperative pneumoconiosis. 中国医药导报, 2018, 15(14): 97-101.

链接本文:

http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2018/V15/I14/97

[1] Chuang CS，Ho SC，Lin CL，et al. Risk of cerebrovascular events in pneumoconiosis patients：a population-based study，1996-2011 [J]. Medicine，2016，95（9）：e2944.
[2] 熊畅，戢艳琼，王梅芳，等.汉方己甲素片联合大容量全肺灌洗术治疗尘肺的临床研究[J].海南医学，2015，26（9）：1271-1273.
[3] Matsuda K，Yamaryo T，Akazawa Y，et al. Primary pleural angiosarcoma associated with pneumoconiosis：an autopsy case [J]. Pathol Int，2015，65（11）：603-607.
[4] 董灵芝，任志艳，董书领.布地奈德混悬液联合复方异丙托溴铵雾化吸入治疗小儿哮喘的疗效及护理[J].实用临床医药杂志，2015，19（8）：97-100.
[5] 中国疾病预防控制中心职业卫生与中毒控制所.GBZ70-2009尘肺病诊断标准[S].北京：人民卫生出版社，2009：59-92.
[6] 郑杨玥.大容量肺灌洗术治疗尘肺病的护理[J].世界最新医学信息文摘，2016，16（96）：416.
[7] DiFusco LA，Verma RK. Whole-lung lavage for pediatric patients with pulmonary alveolar proteinosis [J]. AORN J，2013，98（1）：50-67.
[8] 高丽妮，李宝平，孙治平，等.大容量全肺灌洗治疗尘肺病术后的护理[J].职业与健康，2016，32（12）：1721-1723.
[9] 马国宣，孙玉香，张桂丽.大容量全肺灌洗治疗尘肺病及其他肺疾病并发症分析[J].中国疗养医学，2017，26（7）：773-775.
[10] Abdelmalak BB，Khanna AK，Culver DA，et al. Therapeutic whole-lung lavage for pulmonary alveolar proteinosis： a procedural update [J]. J Bronchology Interv Pulmonol，2015，22（3）：251-258.
[11] 黄月秀.大容量全肺灌洗治疗尘肺病风险因素分析[J].中国疗养医学，2016，25（8）：840-842.
[12] 许承斌，丁明霞，卢丹，等.复方异丙托溴铵联合布地奈德雾化吸入治疗慢性阻塞性肺疾病急性期的疗效观察[J].中国现代医学杂志，2015，25（20）：92-95.
[13] 刘丹，刘玉全，陈艳，等.雾化吸入联合振动排痰在尘肺大容量全肺灌洗治疗中的应用体会[J].临床肺科杂志，2014，19（2）：233-235.
[14] 陈伟伟，王洪武，徐应军，等.大容量全肺灌洗术对尘肺病患者临床症状和脉冲振荡肺功能的影响[J].职业与健康，2014，30（14）：1910-1914.
[15] 王晓云，张建斌，魏彩玲，等.大容量全肺灌洗对尘肺患者呼吸功能影响的Meta分析[J].长治医学院学报，2016， 30（2）：104-107.
[16] 王梅芳，刘玉全，熊畅，等.普米克令舒联合万托林吸入在大容量全肺灌洗治疗尘肺中的作用[J].临床肺科杂志，2013，18（8）：1407-1409.
[17] 陈杰，张江义，鲁翠红.布地奈德联合沙丁胺醇雾化吸入对支气管哮喘急性发作的疗效观察[J].临床肺科杂志，2007，12（10）：1077-1078.
[18] 张映铭，王伟，王彩英，等.重复全肺灌洗术治疗矽肺的远期疗效[J].中华劳动卫生职业病杂志，2013，31（9）：681-684.
[19] 朱晓莺.联合雾化吸入支气管舒张剂治疗煤工尘肺合并COPD67例疗效观察[J].中国医学创新，2011，8（35）：128-129.
[20] 杨怀宇，石江涛.布地奈德联合复方异丙托溴铵雾化吸入对尘肺病大容量全肺灌洗围术期患者的疗效影响[J].中国药房，2017，28（5）：656-659.