Airway Clearance Effect Of Acapella On Acute Exacerbation Of Chronic Obstruvtive Pulmonary Disease With Different Severity

Objective: To observe the airway clearance effect of Acapella on patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)of different severity.Methods : 243 patients with AECOPD who were treated in the Department of Respiratory and critical Medicine of our hospital from April2017 to April 2019 were divided into moderate group(n = 85),severe group(n = 77)and extremely severe group(n = 81)according to their severity.Each group was randomly subdivided into control group,bronchoalveolar lavage(BAL group)and Acapella group,with 12 months follow-up.The short-term and long-term prognosis of each group after different treatments were compared.Results:In comparison of short-term indicators,WBC,Neu%,CRP,PaO2 and PaCO2 in Acapella and BAL groups of moderate,severe patients improved significantly compared with the control group(P<0.05),There was no significant difference between Acapella group and BAL group(P<0.05).Acapella and BAL groups of extremely severe patients of WBC,Neu%,CRP,PaO2 and PaCO2 improved significantly compared with the control group(P<0.05),and BAL group was more significant than the Acapella group.There was no significant difference in antibiotic use time,hospital stay,cost and ventilator utilization rate among different groups.In comparison of long-term indicators,the mMRC score and the frequency of acute exacerbation in the Acapella group were lower than those in the control group and BAL group at each follow-up time point(P< 0.05).and the mMRC in the moderate and severe groups was significantly lower(P<0.05).There was no significant difference in the comparison of 6MWD at each time point of follow-up(P>0.05).Conclusion: Acapella can improve the short-term prognosis of patients with different degrees of AECOPD by enhancing airway clearance,long-term use is of great significance in reducing dyspnea symptoms and reducing the frequency of acute exacerbation.especially in moderate and severe patients,it is worthy of clinical application.