目的:探讨三联雾化吸入疗法在重症哮喘急性发作治疗中的应用效果.方法:选取郑州大学第一附属医院在2017年9月至2020年9月收治的90例重症哮喘急性发作患者,随机分为对照组和观察组,每组45例.对照组给予常规治疗,观察组在此基础上实施三联雾化吸入疗法,比较两组患者的治疗效果.结果:经治疗,观察组治疗总有效率达到了 93.33％,显著高于对照组的77.78％,差异具有统计学意义(P＜0.05).观察组患者的喘息、胸闷、咳嗽、气促和肺部哮鸣音消失时间均短于对照组患者,差异具有统计学意义(P＜0.05).在不良反应发生率方面,两组比较,差异无统计学意义(P＞0.05).结论:三联雾化吸入疗法对成人重症哮喘急性发作的疗效确切,可促进患者临床症状的早期缓解,同时也具有较高的安全性.

Objective To investigate the clinical effect of N-acetylcysteine in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and its effect on the level of oxidative stress in patients with AECOPD.Methods Two hundred and twenty cases of AECOPD patients selected in respiratory department of Shangqiu First People's Hospital in 2013 June 2015 in June,the draw method were randomly divided into two groups,experimental group and control group,each of 110 cases,two groups of patients were given conventional treatment,experimental group while giving N acetyl cysteine treatment,a course of 4 weeks.Results Before the treatment,the activity of GSH-ST in serum of the two groups of patients,inhibit the ability of hydroxyl radical,anti superoxide anion activity determination showed no significant difference (P ＞0.05).After treatment,the serum GSH ST activity,patients in the experimental group,inhibition of hydroxyl radical superoxide anion capacity was significantly higher than that of control group (P ＜0.05).Before the treatment,two groups of patients with PaO2,PaCO2 was no statistically significant difference (P ＞ 0.05).After treatment,the test group of patients with PaO2 [(69.42±4.88) mmHg] was significantly higher than that of control group [(64.57± 5.92) mmHg] (P ＜0.05),the level of PaCO2 [(39.52± 1.88) mmHg] was significantly lower than that of control group [(41.73± 1.96) mmHg] (P ＜0.05).The two groups of patients before treatment,FEV1 ％pred,FEV1 /FVC was no statistically significant difference (P ＞0.05).After treatment,patients in the experimental group FEV1 ％ pred and FEV1/FVC were significantly higher than that of control group (P ＜ 0.05).Conclusions AECOPD patients with N-acetyl cysteine treatment can significantly improve the antioxidant capacity,is conducive to improve the treatment effect.

目的:探讨溶栓、抗凝联合复方血栓通胶囊治疗肺栓塞的临床疗效.方法:选取2014年3月～2016年3月我院收治的肺栓塞患者70例为研究对象,随机分为对照组和观察组各35例.对照组采用溶栓+抗凝治疗,观察组采用溶栓+抗凝+复方血栓通胶囊联合治疗,比较两组治疗效果.结果:观察组患者治疗效果显著高于对照组(P＜0.05);治疗后,两组患者动脉血气检查结果均较治疗前明显改善(P＜0.05),但两组比较差异无统计学意义(P＞0.05).结论:应用溶栓+抗凝+复方血栓通胶囊联合治疗肺栓塞效果显著,可有效改善患者动脉血气,临床应用价值较高.

Objective To explore the effects of tiotropium bromide combined with corbrin capsule on the an-ti-inflammatory action of patients with COPD. Methods 78 COPD patients from January 2014 to December 2015 were randomly divided into the experimental group and the control group,with 39 cases in each group. The control group was given inhaling of tiotropium bromide dry powder,and the experimental group was treated with corbrin cap-sule additional to the therapy given to the control group. The pulmonary function indexes and inflammatory cytokines levels in the two groups were observed before and after the treatment. Results After treatment,the pulmonary func-tion indicators were higher in the experimental group than in the control group(P < 0. 05),the dyspnea score was significantly lower in the experimental group than in the control group(P < 0. 05). The level of IL-8 and TNF-a was lower in the experimental group than in the control group(P < 0. 05). The blood gas indexes were better in the ex-perimental group than in the control group( P < 0. 05). Conclusion Tiotropium bromide combined with corbrin capsule can improve their lung function and reduce airway inflammation in treatment of COPD patients.

Objective To research treatment value by tiotropium bromide combined with salmeterol and fluticasone propionate by inhalation for severe stable chronic obstructive pulmonary disease (COPD) patients. Methods A total of 70 patients with severe stable COPD were randomly divided into group M and group M+S, with 35 cases in each group. Group M received salmeterol and fluticasone propionate by inhalation for treatment, and group M+S received tiotropium bromide combined with salmeterol and fluticasone propionate by inhalation. Comparison was made on curative effect, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and FEV1/FVC before and after treatment between the two groups. Results Group M+S had higher total effective rate (91.43%) than group M (68.57%) (P<0.05). After treatment, both groups had improved FVC, FEV1 and FEV1/FVC, while group M+S had better improvement than group M. Their differences all had statistical significance (P<0.05). Conclusion Combination of tiotropium bromide and salmeterol and fluticasone propionate provides precisely curative effect for severe stable COPD patients. This method can effectively improve clinical symptoms and pulmonary function in patients, and it is worth promoting.

Objective To observe the effects of electric stimulating insular cortex on electrocardiogram(ECG),blood pressure and activity of autonomic nerves in rats.Methods The total of 54 healthy male SD rats were randomly divided into 3 groups:insular cortex group,amygdaloid nucleus group and sham operated group.ECG,Blood pressure and activity of autonomic nerve were observed before and after electric stimulated insular cortex and amygdaloid nucleus.Results Using 500μA,50Hz electric current to stimulate the insular cortex for 1 hour,and arrhythmia was observed.Of total,13 of 18 rats had abnormal ECG;the rate of abnormality was 72%.The change of ECG was various.All of them,tachyarrhythmia was shown in 9 rats,sinus arrhythmias was shown in 5 rats,atrial fibrillation was shown in 2 rats,and there had intraventricular block in 6 rats.Of 11 rats had ST segment depression,of 5 had T wave flatted,of 5 had inversed T wave.Blood pressure and heart rates of the rats of insular cortex group were significantly higher compared with the other groups(P0.05).And plasma norepinephrine in insular cortex group was higher than other groups(P0.05).There had statistically significant between before and after electric stimulation(P0.05).Conclusion The results suggested that the insular cortex is the senior center of controlling cardiac autonomic nerve.Post-injury of it would cause disequilibrium of cardiac autonomic nerve,which can cause plasma norepinephrine higher and reduce cardiac arrhythmia.

Objective:To restrain the behavior of antibiotic drug use and improve the level of using antibiotic drug through analyzing the use of antibacterial information in our hospital.Methods:2014 out-patient prescriptions were randomly checked on February 2006.The antibacterial ratio was calculated and irrational administration information was analyzed.Results:The ratio of antibacterial was 22.34%.The ratio of unreasonably antibacterial associated application was 12.5%.Conclusion:It was necessary to strengthen the thought of using antibacterial reasonably and costrolled the indication strictly,as well as to restrain the behavior of using antibiotic drug.

近年来慢性阻塞性肺病(chronic obstructive pulmonary disease,COPD)患病率、死亡率呈明显上升趋势,且由于肺功能的减退,活动耐力明显下降,康复训练已成为治疗COPD缓解期患者的主要措施之一.在本观察中,对我院30例门诊及住院COPD患者在缓解期进行步行运动和呼吸操训练,取得了满意的治疗效果,现总结报告如下.

目的探讨慢阻肺合并肺部白色念珠菌感染的临床表现、诱因、诊断、治疗和预后.方法回顾2000年8月～2003年4月收治的COPD合并肺部白色念珠菌感染病人38例,均在基础治疗的同时应用抗真菌治疗,疗程30～90d.结果好转34例,(89.5%),无效4例(10.5%)均合并多脏器功能衰竭.结论抗真菌治疗效果满意,预后与早诊断、早治疗和及时去除诱发因素有关.