慢性阻塞性肺疾病不同空间分布肺气肿急性加重期常规治疗预后评价
Prognostic evaluation of routine treatment for acute exacerbation of chronic obstructive pulmonary disease with different spatial distributions of emphysema
付道芳 1文艳梅 1邓正旭 1陈红 1徐治波 1梁宗安2
作者信息
- 1. 成都市第二人民医院呼吸与危重症医学科,四川 成都 610017
- 2. 四川大学华西医院呼吸与危重症医学科
- 折叠
摘要
目的:观察慢性阻塞性肺疾病(COPD)不同空间分布肺气肿急性加重期治疗后的预后情况.方法:选择 2015年10 月～2017 年 2 月成都市第二人民医院COPD急性加重期患者 69 例,根据HRCT结果分为上叶为主肺气肿组 33 例,下叶为主肺气肿组 36 例,收集治疗前的一般情况.所有患者均给予常规治疗,记录患者治疗后的CAT量表测量评分、呼吸困难指数(mMRC评分)、血气分析、肺功能、住院天数,并随访再次住院间隔时间、1 年内急性加重次数.结果:治疗后两组患者的CAT、mMRC评分、第 1 秒用力呼气容积占预计值百分比(FEV1%pred)、第 1 秒用力呼气量/用力肺活量(FEV1/FVC)、氧分压(PaO2)、二氧化碳分压(PaCO2)均较治疗前显著改善,差异有统计学意义(P<0.05),但两组改善程度差异无统计学意义(P>0.05).下叶为主肺气肿患者住院天数显著短于上叶为主肺气肿患者,差异有统计学意义(P<0.05),同时发现下叶为主肺气肿患者再次住院间隔时间与上叶为主肺气肿患者差异无统计学意义(P>0.05);通过对患者长期随访,发现下叶为主肺气肿患者 1 年内急性加重次数显著高于上叶为主肺气肿患者,差异有统计学意义(P<0.05).结论:在急性加重期,下叶为主的肺气肿患者较上叶为主肺气肿患者对常规治疗反应无显著差异,但住院时间更短,急性加重频率更高.
Abstract
Objective To observe of the prognosis of chronic obstructive pulmonary disease with different spatial distributions after routine treatment in acute exacerbation of emphysema.Method 69 patients with acute exacerbation of chronic obstructive pulmonary disease were selected,according to HRCT results,33 cases of upper lobe-based emphysema(ULE)type and 36 cases of lower lobe-based emphysema(LLE)type.General information were established.All patients were given routine treatment,and the CAT scale measurement score,mMRC score,blood gas analysis,lung function,hospitalization days after treatment were recorded,and the next hospitalization interval and the number of acute exacerbations in the next year were followed up.Results CAT,mMRC score,FEV1%pred,FEV1/FVC,PaO2 and PaCO2 levels after treatment were significantly improvement in each group(P<0.05);but compared the upper lobe-based emphysema with the lower lobe-based emphysema,there was no significant difference in the improvement of indicators(P>0.05).The results suggest that the number of hospital stays in patients with lower lobe-based emphysema was signifi-cantly shorter than that in patients with upper lobe-based emphysema(P<0.05),and that the interval between the lower lobe-based emphysema was slightly longer than that in the upper lobe-based emphysema,but with no statistically significant difference(P>0.05);Through long-term follow-up of patients,the number of acute exacerbations in the lower lobe-based emphysema was significant-ly higher than that in the upper lobe-based emphysema(P<0.05).Conclusion In the acute exacerbation period,there was no signifi-cant difference in the response to conventional treatment between the patients with upper lobe-based emphysema and those with lower lobe-based emphysema,and the hospital stay may be shorter,but the AE in one year may also be more frequent.
关键词
慢性阻塞性肺疾病/肺气肿/不同空间分布/急性加重期/常规治疗Key words
Chronic obstructive pulmonary disease(COPD)/Emphysema/Different spatial distribution of/Acute exacerbation period/Conventional therapy引用本文复制引用
出版年
2024
NETL
NSTL
万方数据