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目的探讨慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)急性加重期的临床治疗。方法2005年1月至2008年12月诊治的92例COPD急性加重期,常规给予持续低流量吸氧;第3代头孢菌素或左氧氟沙星严重者给予亚胺培南(或)西司他丁等抗感染;哮喘重者吸入β2-体激动剂或静脉滴注氨茶碱、糖皮质激素;维持水电解质平衡;止咳化痰、强心利尿剂;必要时给予机械通气等治疗。结果显效54例,有效32例,无效6例,死亡2例,死亡原因病程长、多器官功能受损、基础肺功能较差、体质及营养状况欠佳。结论COPD急性加重期病情多种多样,通过有效控制感染、解除气道痉挛改善通气、控制性氧疗、加强营养支持、积极处理并发症以改善患者的预后,提高其生活质量。
Objective To investigate the clinical treatment of chronic obstructive pulmonary disease (COPD) in acute exacerbation. Methods From January 2005 to December 2008, 92 patients with acute exacerbation of COPD were treated with continuous low-flow oxygen inhalation. Third-generation cephalosporins or levofloxacin were given imipenem or cilastatin Anti-infection; asthma severe inhaled β2-body agonist or intravenous aminophylline glucocorticoid; to maintain water and electrolyte balance; cough and phlegm, cardiac diuretics; if necessary, given mechanical ventilation and other treatment. The results were 54 cases markedly effective in 32 cases, 6 cases were ineffective and 2 cases died. The cause of death was long, the function of multiple organs was impaired, the basic lung function was poor, and the physical and nutritional status were poor. CONCLUSIONS: In the acute exacerbation stage of COPD, there are many kinds of exacerbations. By effectively controlling infection, relieving airway spasm, improving ventilation and controlled oxygen therapy, strengthening nutritional support, and actively handling complications to improve patient’s prognosis and improve their quality of life.