目的观察氨茶碱联合呼吸功能训练治疗慢性阻塞性肺疾病(COPD)患者的临床疗效。方法选择80慢性阻塞性肺疾病(COPD)患者,依照随机数字表法将其随机分为2组,在给予常规治疗的基础上,对照组(n=40)单纯采用氨茶碱治疗,观察组(n=40)采用氨茶碱联合呼吸功能训练联合治疗;观察并对比2组患者的临床疗效。结果相对于治疗前,2组患者治疗后的各项肺功能指标、肺动脉压、SGRQ评分均明显改善(P<0.05),且观察组改善情况优于对照组(P<0.05)。结论氨茶碱联合呼吸功能训练治疗慢性阻塞性肺疾病(COPD),能够显著改善患者的肺功能,提高患者的生存治疗,临床疗效令人满意。
Objective To explore the relevant misdiagnosis causes and strategies of chronic obstructive pulmonary disease(COPD) during hospitalization.Methods We retrospectively analyzed 1047 inpatients whose admitted diagnosis and discharged diagnoss had correlation with COPD during January 2010 and June 2011.Results The admitted diagnosis(acute exacerbation of COPD) were identical with discharge in 983 cases from 1047,while there was a 6.1% misdiagnosis rate in 64 cases whose admitted diagnosis were different from that of discharge.45 cases were diagnosed as COPD on admisson,but were diagnosed as others disease on discharge form hospital.Ten cases with chronic bronchitis,7 cases with pneumothorax,6 cases with bronchiectasis,6 cases with coronary disease accompanied by left heart failure,4 cases with bronchial asthma,3 cases with tuberculosis,2 cases with idiopathic pulmonary fibrosis,2 cases with acute myocardial infarction,2 cases with cerebral infarction,1 case with pulmonary embolism,1 case with hypoglycemia and 1 case with diffuse panbronchiolitis were misdiagnosed as COPD on admission.But there were 19 cases who were not diagnosed as having COPD upon admission but were definitely diagnosed as having COPD upon discharge.12 cases with left heart insufficiency of coronary heart disease,3 cases with bronchial asthama,3 cases with acute infarction of the brain,1 case with pneumonia were misdiagnozed on admission.Conclusion The misdiagnosis rate of COPD is still relatively high,although it is a common disease.Earnest history inquiry,careful physical examination and comprehensive analysis of patients' data are helpful in avoiding misdiagnosis of COPD.
自发性气胸是肺科的四大急症之一,也是内科的急诊范畴.一般资料中报道占呼吸系疾病的7%～10%,其中一部分较为难治.所谓难治性气胸,目前诊断标准还没有统一,我们初定为:①气胸病程长,肺复张时间在4周以上者;②气胸反复多次发作＞3次;③全身情况差,肺气肿,肺大疱明显,肺功能差,按一般气胸治疗效果不理想者;④肺结核,肺部感染不易控制者,有局限性多腔性气胸,又有胸膜粘连者,影响气胸愈合者.
