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目的探讨不同浓度硫酸镁面罩氧气雾化吸入对慢性阻塞性肺疾病急性加重期(AECOPD)患者肺功能和氧代谢的影响。方法选取中山市火炬开发区医院AECOPD患者160例,随机分为治疗组120例与对照组40例,治疗组在常规治疗基础上给予75%高渗硫酸镁溶液(A组40例)、7.5%等渗硫酸镁(B组40例)和3.2%硫酸镁(C组40例)溶液20 ml氧气雾化吸入,对照组给予α-糜蛋白酶雾化吸入,比较治疗前、治疗后肺功能的变化,治疗2、4、7 d血流动力学指标的变化及雾化后1~7 d咳痰量的改变。结果 B组的临床有效率为97.50%,明显高于其他组,差异具有统计学意义(P<0.05),B组的肺功能指标FVC%、FEV1%和FEF改善程度均明显优于对照组,但A组、B组、C组间比较差异无统计学意义(P>0.05),B组雾化后1~7 d痰量明显减少,治疗2、4、7 d血流动力学指标Pa O2和Pa CO2均明显改善,与其他组比较差异具有统计学意义(P<0.05)。结论不同浓度硫酸镁面罩氧气雾化吸入均可有效稀释痰液,缓解支气管痉挛,改善肺功能和血流动力学指标,其效果优于α-糜蛋白酶,其中以等渗硫酸镁效果最佳,有较显著的临床意义。
Objective To investigate the effects of oxygen atomization inhalation with different concentrations of magnesium sulfate mask on pulmonary function and oxygen metabolism in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods 160 patients with AECOPD in Zhongshan Torch Development Hospital were randomly divided into treatment group (120 cases) and control group (40 cases). The treatment group was given 75% hypertonic solution of magnesium sulfate (A group, 40 cases), 7.5% Twenty ml oxygen inhalation of isotonic magnesium sulfate (40 cases in group B) and 3.2% magnesium sulfate (40 cases in group C) were inhaled, and the control group was treated with inhalation of α-chymotrypsin. The changes of lung function before and after treatment were compared , 2, 4, 7 d after treatment, and changes of sputum volume from 1 to 7 days after nebulization. Results The clinical effective rate in group B was 97.50%, which was significantly higher than that in other groups (P <0.05). The improvement of pulmonary function indexes FVC%, FEV1% and FEF in group B were significantly better than those in control group, However, there was no significant difference between group A, group B and group C (P> 0.05). In group B, the amount of sputum 1 to 7 days after nebulization was significantly reduced, and the hemodynamic parameters Pa O2 And Pa CO2 were significantly improved compared with other groups was statistically significant difference (P <0.05). Conclusion Different levels of magnesium sulfate mask aerosol inhalation can effectively dilute the sputum, relieve bronchial spasm, improve pulmonary function and hemodynamic indicators, the effect is better than α-chymotrypsin, of which the best isotonic magnesium sulfate, Have more significant clinical significance.