脈沖振蕩技術在慢性阻塞性肺疾病中的臨床應用

劉興華 柳東偉葉見輝

【摘要】 目的：探討脈沖振蕩技術在慢性阻塞性肺疾病中的臨床應用價值。方法：選取2018年6月-2019年6月本院收治的80例慢性阻塞性肺疾病患者為A組，選取同期本院20例常規肺功能檢查正常但存在慢阻肺高危因素暴露者為B組，另選取同期本院20例健康體檢者為C組。三組均予以脈沖振蕩技術檢查及常規肺功能檢查。比較三組脈沖振蕩技術檢查及常規肺功能檢查結果;比較B、C組脈沖振蕩技術檢查結果;分析脈沖振蕩技術指標和常規肺功能指標相關性。結果：A組第1秒用力呼氣量（FEV1）和第1秒用力呼氣容積占用力肺活量百分比（FEV1/FVC）最低，三組FEV1和FEV1/FVC比較，差異均有統計學意義（P<0.05）。A組X5最低，而Zrs、R5、Fres、R20和R5～R20均最高;三組Zrs、R5、Fres、X5、R20及R5～R20比較，差異均有統計學意義（P<0.05）。C組的Zrs、R5、Fres、R20及R5～520均低于B組，而X5略高于B組，但差異均無統計學意義（P>0.05）。FEV1和FEV1/FVC與X5呈正相關，而與Zrs、R5、Fres和R5～R20均呈負相關（P<0.05）;其中Fres與FEV1呈高相關性（r=-0.764）。結論：脈沖振蕩技術肺功能檢測結果能客觀反映氣道阻力，與常規肺功能指標有明顯相關性，可以作為一種科學有效的臨床診斷手段加以推廣。

【關鍵詞】 脈沖振蕩技術 慢性阻塞性肺疾病

[Abstract] Objective： To investigate the clinical application value of pulse oscillation technique in chronic obstructive pulmonary disease. Method： A total of 80 patients with chronic obstructive pulmonary disease admitted to our hospital from June 2018 to June 2019 were selected as group A. 20 patients with normal routine pulmonary function examination but high risk exposure of chronic obstructive pulmonary disease in our hospital during the same period were selected as group B， and 20 healthy patients in our hospital during the same period were selected as group C. All three groups were examined by pulse oscillation technique and routine pulmonary function. The results of pulse oscillation technique and routine pulmonary function examination were compared among three groups. The results of pulse oscillation technique in group B and C were compared. The correlation between the pulse oscillation technique index and the routine pulmonary function index was analyzed. Result： The forced expiratory volume in the first second （FEV1） and the percentage of forced expiratory volume in forced vital capacity in the first second （FEV1/FVC） in group A were the lowest， and the FEV1 and FEV1/FVC of the three groups were compared， the differences were statistically significant （P<0.05）. The X5 of group A was the lowest， while the Zrs， R5， Fres， R20 and R5～R20 were the highest. The Zrs， R5， Fres， X5， R20 and R5～R20 in the three groups were compared， the differences were statistically significant （P<0.05）. The Zrs， R5， Fres， R20 and R5～R20 of group C were lower than those of group B， while the X5 was slightly higher than that of group B， but the difference was not statistically significant （P>0.05）. FEV1 and FEV1/FVC were positively correlated with X5， while negatively correlated with Zrs， R5， Fres and R5～R20 （P<0.05）. Among them， Fres and FEV1 were highly correlated （r=-0.764）. Conclusion： Pulse oscillation technique can objectively reflect airway resistance， and has obvious correlation with routine pulmonary function related indicators， so it can be promoted as a scientific and effective clinical diagnostic method.[Key words] Pulse oscillation technology Chronic obstructive pulmonary diseaseFirst-authors address： Dongguan Hospital of Integrated Chinese and Western Medicine， Dongguan 523000， China

慢性阻塞性肺疾病是一種慢性呼吸系統疾病，主要特征體現為氣流受限和持續的呼吸道癥狀[1]。該病不僅嚴重影響患者生命健康，也給我國醫療機構帶來嚴重的負擔，而且我國慢阻肺漏診率與誤診率仍相對較高[2-4]。因此積極尋求相關更為精準成熟的診斷技術，對于慢性阻塞性肺疾病患者而言至關重要。常規的肺功能檢測對患者的配合要求嚴格，而且操作相對復雜，對人員技術要求較高，對于一些中、重度患者，特別是老年患者的配合程度相對較差，對檢測結果的準確性造成相應不良影響[5-6]。本研究將脈沖振蕩診斷技術運用于慢性阻塞性肺疾病的檢查中探討其價值，現報道如下。……