Objective To investigate the application of self - efficacy theory in asthmatic patients'nursing Methods 179 bronchus asthma outpatients from respiratory department of our hospital during 2007 - 3 to 2008 - 5 were randomly divided into intervention and control groups, conventional therapy and nursing were given to both groups, the intervention group was applied enhancing self - efficacy's nursing ways and methods on the basis of conventional therapy and nursing. Self - efficacy questionnaire was carried out and lung function was tested at admission and 3 - month post - therapy. Results Two groups had no statistically significant ( P > 0. 05 ) in GSES score at admission. After 3 - month, the GSES score of intervention group was significantly improved ( P < 0. 05 ) compared with that of control group; the levels of FVC, FEV1 and PEFR of both group were significantly increased (P < 0. 05) after intervention. Conclusions Self - efficacy theory can improve therapeutic efficacy of asthmatic patients.

目的 探讨健康教育对哮喘患者生命质量的影响.方法 选择103例门诊就诊的支气管哮喘患者,在常规治疗的基础上,进行健康教育:心理护理、家庭支持、饮食指导、体育锻炼、用药指导.健康教育前及健康教育后3个月由专科护士采用交谈法对生命质量进行评估,同时测定肺功能.结果 经过3个月的健康教育,患者的活动受限、回避刺激物、哮喘症状、哮喘症状、心理情绪、刺激物反应、对疾病的担心等指标与健康教育前比较,差异有统计学意义(P＜0.01);健康教育后肺功能FVC、FEV1和PEFR均有显著提高(P＜0.01).结论 健康教育可以提高哮喘患者对于疾病的认识,提高生命质量。

Objective:To investigate the effect of ultrasonic atomization surface anesthesia in fiber bronchoscope examination.Methods:Eighty patients proceeding fiber bronchoscope examination were randomly divided into two groups according to anesthesia,40 cases in each group.Patients in control group were receipted traditional anesthesia.Patients in trial group were receipted ultrasonic atomization surface anesthesia.Following index were observed:change of blood pressure,heart rate,respiration rate,pulse oxygen saturation during fiber bronchoscope examination.Frequency of added drug,cough degree,examination time,effect of anesthesia.Results:Compared control group,frequency of added drug,cough degree,examination time in trial group decreased significantly(P0.01).The rate of anesthesia excellent was 30% in control group and 57.5% in trial group,there was significant different(P0.01).Conclusion:There have a satisfied anesthesia effect,safety process of inserting fiber bronchoscope,stable homodynamic effect using ultrasonic atomization surface anesthesia in fiber bronchoscope examination,it is valuable to popularize the new means.

目的:探索老年慢性阻塞性肺病(COPD)早期诊断的敏感指标.方法:选择100例COPD患者,按病情轻重分为单纯慢性支气管炎组及轻、中、重度肺气肿组,对所有患者的肺功能做全面的检测,并对结果作出分析.结果:COPD患者MMEF和FEF75降低比例最大,单纯慢支组明显降低,VC、FEV1、MVV、DLCO随病情加重逐渐降低;RV和RV/TLC随病情加重逐渐升高;MVV和FEV1在轻度肺气肿时已有明显降低,而DLCO和VC则在中、重度肺气肿时才明显下降.结论:MMEF和FEF75为检测早期COPD患者的敏感指标,对COPD患者应定期、及时作肺功能检测, 以防止不可逆的阻塞性肺气肿的发生.

Objective To evaluate the diagnostic value of bronchofibroscope in drawing materials in proper order for patients with lung cancer.Methods The materials for pathological examination of 180 cases with lung cancer were drawn by aspiration-needle biopsy,ring clamp biopsy and brush biopsy in proper order in the bronchofibroscope operation.The Positive rate of lung cancer was analyzed.Results The positive rate of aspiration-needle,ring clamp and brush biopsy was 70%,80% and 67% respectively,There was no statistical difference.The positive rate of aspiration-needle biopsy combined with ring clamp biopsy and brush biopsy was 91%,there was a significant difference(P0.01).Conclusions There was an important diagnostic value using bronchofibroscope to draw the materials in proper order from patients with lung cancer.The aspiration needle biopsy combined with ring clamp and brush biopsy can improve the positive rate of lung cancer diagnosis.

目的总结纤维支气管镜在支气管异物中的诊治价值。方法对纤维支气管镜诊治成人支气管异物17例的临床资料进行回顾性分析。结果本组17例均治愈,成功率为100%,其中15例均1次取出,2例第2次取出;钳取异物时间:最短10min,最长50min。结论纤维支气管镜是目前诊治支气管异物的最有效方法。

1 病例资料 女,23岁.因咽痒、声嘶、轻咳1个半月就诊.来我院前在当地医院按咽喉炎、上呼吸道感染治疗2周末见好转,后到另一医院就诊,亦按上述疾病治疗2周仍未见好转.既往体健.查体:咽部稍充血,心肺听诊未闻及异常.

Objective:To observe the difference of pulmonary function and bronchodilatation test of the cases with asthmatic patients in their alleviative period.Methods:Analyzing the result of 36 cases with senile asthma group,that were in their alleviative period,28 cases in the adolescent age that suffered asthma in their alleviative period.Their pulmonary function and bronchodilatation test were checked and compared.Results: In the senile asthmatic patients during their alleviative period,91.67% had abnormal pulmonary function and 58.33% had positive reaction in bronchodilatation test.Index compared with 57.14% and 92.86% in the adolescent age.There were significant differences between senile asthma group and adolescent age group.Conclusions: The pulmonary function is still abnormal in the cases with asthma during their alleviative period,the ventilation is limited.The treatment is still necessary during their alleviative period.The pulmonary function must be checked regularly.

目的:了解肺弥散功能测定在慢性阻塞性肺气肿和支气管哮喘的鉴别和诊断作用。方法:本文对82例慢性阻塞性肺气肿患者,36例支气管哮喘患者进行肺容量、通气功能和弥散功能测定,结果在两组间和与正常人之间进行比较。结果:慢性阻塞性肺气肿和支气管哮喘患者的残气容积/肺总量(RV/TLC)值明显高于正常人(P<0.01);只有慢性阻塞性肺气肿患者的弥散功能(DLco)值明显下降,与正常人和支气管哮喘患者比较(P<0.01)有差异。结论:肺弥散功能测定有助于慢性阻塞性肺气肿和支气管哮喘的鉴别和诊断。

我院呼吸疾病研究所1980年1月～2005年12月行纤维支气管镜(纤支镜)检查共 5 076例,其中活检大出血致死2例.在此,我们对纤支镜活检术导致大出血这一严重并发症做分析探讨.

Objective To comprehend the diagnostic value of bronchofiberoscope examination on heamoptysis in the middle-aged and aged patients.Methods An retrospective analysis was made on bronchofiberoscope examination on heamoptysis with the pliers and brush.Results The final causes of 256 cases with heamoptysis in the middle-aged and aged patients were inflammation in 52.73%,tumor in 25.78%,bronchiectasises in 7.03%,bronchial tuberculosis in 5.47%.Conclusion Bronchofiberoscope examination is clinical utility value to diagnose the reasons of heamoptysis in the middle-aged and aged patients.We must especially watch out for lung cancer.

Objective:To evaluate the effect of Mucosolvan on the treatment of Chronic Obstructive Pulmonary Disease(COPD) at stage of acute exacerbation by oxygen startup atomization inhalation.Methods: Sixty-four cases with acute exacerbation of COPD were seperated into control group and observation group randomly and all the cases were treated with synthesis.The observation group was administrated with inhaling Mucosolvan while the control group was with α-protease.Their effects were evaluated after 7 days.Results:The two groups had no difference of effective power between each other.But the incidence of clinical control plus excellece of observation group was higer than that of control group.No obvious side effects were observed.Conclusion:Atomization inhaling Mucosolvan is an effective and safe way to treat cases with acute exacerbation of COPD.

AIM: To investigate the relationship among MCP-1 and monocyte chemoattract protein activity (MCA) and pathogenesis of lung cancer. METHODS: 173 patients were involved in the study and divided into three groups: group A: lung cancer group (60 patients); group B: benign lung disease group (55 patients) and group C: healthy control group (58 patients). MCP-1 level and MCA in bronchoalveolar lavage fluid (BALF) were measured. RESULTS: The concentration of MCP-1 and MCA in BALF in group A were much higher than those in group B and group C (P0.01), but the increase in MCA were not in direct proportion to the increase in MCP-1 in the patients with lung cancer. CONCLUSION: Monocyte chemoattract activity of the patients with lung cancer may be insufficient.

Aim: To investigate the changes of pulmonary function and quality of life (QOL) of patients after pneumonectomy, and to discuss the effect of rehabiliation training on pulmonary function and QOL of patients after pneumonectomy. Methods: Sixty patients with pneumonectomy were randomly divided into rehabilitation group and control group, with 30 in each group. Rehabilitation group was treated with routine treatments plus systematic rehabilitation training, while control group only used routine treatments. After 1-year follow-up, the changes in pulmonary function and QOL of the two groups were compared at 3 months before operation, and 3, 6, 12 months after operation. Results: Pulmonary function was declined 3 months after operation. QOL had no changed. There was no significant difference between the two groups (F = 1.395 - 1.705, P > 0.05). Pulmonary function of rehabilitation group was recovered to the normal level 6 months after operation, while only recovered to 80% of the normal level in the control group. Pulmonary function and QOL had significant difference between the two groups(F = 3.901 - 4.415, P < 0.05). Twelve months after operation, pulmonary function of the two groups was recovered to the preoperative level, and 20% of the patients in the rehabilitation group recovered normal level. There were significant difference between the two groups(F = 3.958 - 4.171, P < 0.05). QOL of the two groups was markedly enhanced, which was better in the rehabilitation group (F = 11.354, P < 0.01). Conclusion: Improvement in pulmonary function and QOL of patients after pneumonectomy is directly related with stabilization of illness, which was beth better rehabilitation training can improve the reconstruction of pulmonary function and enhance the QOL of patients.

目的研究纤维支气管镜在诊断呼吸系统疾病中的临床应用价值.方法对我院近3年多来经纤维支气管镜诊断的呼吸道疾病680例结合文献进行临床综合分析.结果未见异常130例(19.12%),炎症表现306例(45%),肺癌表现231例(33.97%),弥漫性肺部病变6例(0.88%),异物7例(1.03%).结论纤维支气管镜在呼吸系统疾病的诊断、治疗、监护和抢救方面均有重要的临床应用价值.

目的:探讨白细胞介素13(IL-13)在支气管哮喘发病机制中的作用.方法:采用酶联免疫法(ELISA)测定23例哮喘患者外周血单个核细胞(PBMC)培养上清中IL-13、峰流速仪测定最大呼气流速(PEF)占预计值%及直接测定外周血嗜酸细胞(Eos),并与20名健康正常者的结果进行比较.结果:哮喘患者PBMC中IL-13水平(5.54±1.075)、外周血Eos(0.398±0.115)×109/L水平高于对照组的IL-13水平(3.13±0.837)、Eos水平(0.155±0.082)×109/L(P＜0.01),哮喘患者PEF(59.0±10.28%)明显低于正常对照组PEF(87.2±10.87%)(P＜0.01).IL-13与Eos水平呈显著正相关(r＝0.88,P＜0.01),IL-13与PEF呈显著负相关(r＝-0.75,P＜0.01).结论:哮喘发作时IL-13表达水平及Eos明显增高,提示IL-13可能通过对Eos的调节从而参与哮喘的发病过程.

OBJECTIVE:To observe the preventing effect of chimonin on guinea pigs asthma and explore its partly action mechanism.METHODS:67 guinea pigs were divided into five groups at randomicy:the groups of normal control,asthma,chimonin,dexamethasone and chimonin with dexamethasone.The ratio of wet lung weight to body weight,the period needed for inducing asthma attack and the sustained period of asthma episode were observed.The concentration of nitric oxide(NO) and endothelin-1(ET-1) in serum and bronchoalveolar lavage fluid(BALF) were detected respectively.RESULTS:① the inducing and sustained period of asthma episode in group chimonin were distinctly longer than those in group asthma;the occurrence rate of spasm in group chimonin was evidently lower than group asthma;the inflammatory reaction of the lung tissues in group chimonin relieved obviously and this change was similar to the group dexamethasone.② The NO in serum and ET-1 of BALF in group chimonin were lower than group asthma and similar to the group dexamethasone.CONCLUSION:chimonin can partly prevent asthma episode and this role is similar to glucocorticoid.It plays the role partly by reducing the level of NO and ET-1 in the body.