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目的:探讨慢性阻塞性肺疾病(COPD)急重期合并肺部真菌感染的临床相关因素,评价盐酸氨溴索对该疾病的临床治疗效果。方法:回顾分析2011年4月-2015年8月呼吸内科住院的100例COPD急性加重期合并肺部感染患者临床资料,按治疗方法分成对照组与观察组,每组患者50例。对照组患者常规用药,观察组在对照组基础上加入盐酸氨溴索联合治疗,对比两组患者的治疗效果。结果:总有效率:对照组75%,观察组90%,差异显著(P<0.05);急性生理与慢性健康评分(APACHEⅡ)和临床肺部感染评分(CPIS),观察组都显著低于对照组患者,差异有统计学意义;住院时间与临床症状减轻时间观察组比对照组短,差异明显(P<0.05)。经分析,抗菌药物、激素长期应用、合并糖尿病、低蛋白血症是导致感染的重要因素。结论:COPD急重期合并肺部真菌感染相关因素较为复杂,临床诊疗需结合患者实际情况;盐酸氨溴索应用于此病治疗,可显著改善患者临床症状,缩短疗程,促进患者身体康复。
Objective: To investigate the clinical factors associated with acute pulmonary fungal infection in patients with chronic obstructive pulmonary disease (COPD) and to evaluate the clinical efficacy of ambroxol hydrochloride in the treatment of this disease. Methods: The clinical data of 100 patients with acute exacerbation of COPD admitted to Department of Respiratory Medicine from April 2011 to August 2015 in our hospital were retrospectively analyzed. According to the treatment methods, the patients were divided into control group and observation group with 50 cases in each group. The patients in the control group were given conventional drugs. The observation group was given ambroxol hydrochloride combined with the control group on the basis of the control group, and the therapeutic effect was compared between the two groups. Results: The total effective rate was 75% in the control group and 90% in the observation group, with significant difference (P <0.05). The APACHEⅡ and CPIS scores in the observation group were significantly lower than those in the control group Group patients, the difference was statistically significant; hospitalization time and clinical symptoms reduce time observation group shorter than the control group, the difference was significant (P <0.05). After analysis, long-term use of antibiotics, hormones, diabetes mellitus, hypoproteinemia is an important factor leading to infection. Conclusions: The related factors of pulmonary fungal infection in acute exacerbation of COPD are complicated. The clinical diagnosis and treatment should be combined with the actual situation of the patients. Ambroxol hydrochloride can be used in the treatment of this disease, which can significantly improve the clinical symptoms, shorten the course of treatment and promote the physical rehabilitation.