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Objective To investigate clinical efficacy of additive LiuJunZi decoction in treatment of patients with chronic obstructive pneumonia ( COPD) of both lung and spleen deficiency in stable phase.Methods A total of 58 patients with deficiency of both lung and spleen type stable COPD patients were randomly divided into treatment group and control group by a random number table, 29 cases in each group, patients in two groups were treated with salmeterol and fluticasone propionate powder for inhalation.On this basis, the treatment group were given additive Liujunzi Decoction, orally, with 3 months treatment.The clinical signs and symptoms of patients, pulmonary function, index of sputumand acute attack proportion in a year were observed and compared.Results After different treatment, total efficiency was 93.1% in treatment group, which was obviously higher than 65.5%in control group (P<0.05).After treatment, the values of FEV1 and FEV1/FVC improved compared with before treatment, and the above indexes of treatment group significantly improved compared with control group (P<0.05).The HDACs activety, levels of TNF-αand IL-8 mproved compared with before treatment, and the above indexes of treatment group significantly improved compared with control group (P<0.05).The acute attack was two cases in treatment group(6.9%), seven cases in control group(24.1%), but the difference had no statistically significant.Conclusion The additive Liujunzi decoction in the treatment of both lung and spleen deficiency type chronic obstructive pulmonary disease ( COPD) in stable phase has exact clinical curative effect, can significantly improve clinical symptoms and laboratory indexes, control the progression of the disease, and improve life quality of the patients.
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Objective To observe the curative effect of pure 1 25 I treatment to non-small cell lung cancer combined obstructive pneumonia.Methods 28 cases with non-small cell lung cancer combined obstructive pneumonia were enrolled.Treatment planning system was used to calculate the dosage of tumor and make up the therapeutic plan.CT-guided radiation treatment of particle im-plantation was then conducted.Follow-up was done to evaluate the curative effect one to two months after treatment.Results The total effective rate of therapeutic evaluation was 89.3%.Clinical symptoms including chest distress,hard breathing and fever were ameliorated remarkedly.Life quality score of appetite and fatigue was also improved.White blood cell reduced significantly in blood routine examination.Conclusion There is a definite curative effect of pure 1 25 I treatment to non-small cell lung cancer combined ob-structive pneumonia.
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ObjectiveTo explore the surgical methods and its efficacy on severe chronic obstructive pneumonia disease (COPD) with spontaneous pneumothorax.MethodsClinical features and surgical efficacies of 16 cases of severe COPD were analyzed.Results No death occurred and all patients recovered and discharged.The lung function index including subjective symptoms,motor ability and endurance in 14 cases showed obvious improvement compared with those before combination of pneumothorax.Two patients improved to the level before surgery.ConclusionThe lung function index of patients with severe COPD and pnumothorax can be relatively less restricted and open-chest surgery should be performed as soon as possible.Linear nailing and simple lung volume reduction surgery are recommended to improve lung function,shorten operation time and reduce surgical risks.
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Objective To assess the clinical efficacy of budesonide in combination with salbutamol sulfate and ambroxol through fog inhalation in the treatment of elderly patients older than 70 years with acute exacerbation chronic obstructive pneumonia disease (AECOPD). Methods A total of 58 elderly patients older than 70 years with AECOPD were randomly assigned to receive medication of budesonide in combination with salbutamol sulfate and ambroxol through fog inhalation in addition to conventional therapy ( n = 58 treatment group). In the control group,56 AECOPD patients received conventional therapy (including oxygen uptaking,anti-infection, medication, relieving asthma, eliminating sputum, nutritional support, et al). Results The overall effective rate in the treatment group was 76.79% (43/56) ,which was significantly lower than that in the control group 89. 66% (52/58) ( χ2 = 6. 46, P = 0. 007 ). Blood gas analysis ( pH, PaCO2, PaO2 ) and lung function ( FEV1/FVC, FEV1 occupy prospect% ) outcome were significantly improved after treatment (Ps ＜ 0.05 ). We found no significant difference in the comparison of the blood gas analysis improvement between the treatment and control ( Ps ＞ 0. 05 ), whereas significant difference was observed in the improvement on lung function between the two groups (P ＜ 0. 05 ). Conclusion Combined budesonide with salbutamol sulfate and ambroxol through fog inhalation in addition to conventional therapy has a significant better effect and less side effects on the treatment of AECOPD patients older than 70 years.
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Objective To explore the diagnosis rate.pathology types and positive rate of cancer cell in spu-tum of early central pulmonary carcinoma in three obstructive signs on chest X ray screened by fiberbromchoscope.Methods 326 cases of three obstructive signs with high risk of lung cancer were screened for central pulmonarycarcinoma by spiral CT.biopsy by fiberbronchoscope and cytological examination of sputum.Results 32 patients were diagnosed with central pulmonary carcinoma,with morbidity of 9.8%.In these patients,21 were confirmed with obstructive pneumonia(65.6%),7 with obstructive atelectasis(21.9%),4 with obstructive emphysema(12.5%);In terms of pathology type,16 cases were defined as squamous cell carcinoma(50.0%),9 as small cell carcinoma(28.1%).3 were as large cell carcinoma(9.4%).2 were as adenocarcinoma(6.3%),1 as admosquamous carci-noma(3.1%),1 as bronchial gland carcinoma(3.1%);cancer cell could be found in sputum of 5 patients of 32 cases,among them,it was found in 3 of 21 patients with obstructive pneumonia(14.3%),1 in 7 patients with ob-structive atelectasis(14.3%),1 in 4 patients with obstructive emphysema(25.0%).Conclusion The prevelance of early central pulmonary carcinoma in three obstructive signs on chest X-ray is 9.815%,in which squamous carci-noma and small-cell carcinoma are common in pathology type.Screening can increase the detection rate of early pul-monary carcinoma.
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Endobronchial foreign bodies are difficult to diagnose as the cause of obstructive pneumonia and atelectasis, However, once discovered, they can generally be removed, leading to an immediate and dramatic resolution of the symptoms. Occasionally, small foreign bodies that lodge in the peripheral airway are often initially asymptomatic but become symptomatic several years later. We reported a case of obstructive pneumonia and massive hemoptysis caused by a foreign metallic body. The patient knew that the foreign body was lodged in the peripheral airway on the chest X-ray, but did not want treatment. Several years later, he had a massive hemoptysis and obstructive pneumonia. Removal with a flexible bronchoscope failed, but the metallic foreign body was self-expectorated by coughing after the procedure. The pneumonia was resolved after removing the foreign body. The patient improved and was discharged without any sequela.
Subject(s)
Humans , Bronchoscopes , Cough , Foreign Bodies , Hemoptysis , Pneumonia , Pulmonary Atelectasis , ThoraxABSTRACT
Pulmonary gangrene is a rare complication of severe pulmonary infection in which a pulmonary segment or lobe is sloughed. It is a part of a spectrum of disease in which lung tissue is devitalized(such as necrotizing pneumonia, pulmonary abscess), but apart from them, pulmonary gangrene has mo re extensive area of necrosis and thrombosis of large vessels plays a prominent role in the pathogenesis. We experienced a case of pulmonary gangrene in 71 year old female obstructive pneumonia patient with non-small cell lung carcinoma. She complained high fever, chill and despite treatment with antibiotics, pneumonia progressed to empyema. At that time chest radiograph showed a large cavity including sloughed lung tissue, freely moving to dependent position at both lateral decubitus view. RML and RLL were resected and compression of pulmonary vessels by enlarged lymph nodes was observed. Defervescence was obtained immediate postoperative period and the patient was discharged after infection control with antibiotics, chest tube drainage. The perivascular ly mph nodes dissected during lobectomy were proved to be reactive hyperplasias. We speculated that the carcinoma caused obstructive pneumonia, in turn, resulted in reactive hyperplasia of the draining lymph nodes surrounding the large vessels and finally the lung tissues supplied by them necrotized and sloughed.
Subject(s)
Aged , Female , Humans , Anti-Bacterial Agents , Chest Tubes , Drainage , Empyema , Fever , Gangrene , Hyperplasia , Infection Control , Lung , Lymph Nodes , Necrosis , Pneumonia , Postoperative Period , Radiography, Thoracic , ThrombosisABSTRACT
Pulmonary gangrene is a rare complication of severe pulmonary infection in which a pulmonary segment or lobe is sloughed. It is a part of a spectrum of disease in which lung tissue is devitalized(such as necrotizing pneumonia, pulmonary abscess), but apart from them, pulmonary gangrene has mo re extensive area of necrosis and thrombosis of large vessels plays a prominent role in the pathogenesis. We experienced a case of pulmonary gangrene in 71 year old female obstructive pneumonia patient with non-small cell lung carcinoma. She complained high fever, chill and despite treatment with antibiotics, pneumonia progressed to empyema. At that time chest radiograph showed a large cavity including sloughed lung tissue, freely moving to dependent position at both lateral decubitus view. RML and RLL were resected and compression of pulmonary vessels by enlarged lymph nodes was observed. Defervescence was obtained immediate postoperative period and the patient was discharged after infection control with antibiotics, chest tube drainage. The perivascular ly mph nodes dissected during lobectomy were proved to be reactive hyperplasias. We speculated that the carcinoma caused obstructive pneumonia, in turn, resulted in reactive hyperplasia of the draining lymph nodes surrounding the large vessels and finally the lung tissues supplied by them necrotized and sloughed.