Journal of Mazandaran University of Medical Sciences
مجله دانشگاه علوم پزشکی مازندران
J Mazandaran Univ Med Sci
Medical Sciences
http://jmums.mazums.ac.ir
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2023
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مقایسه تأثیر سالبوتامول از طریق نبولایزر و اسپری با و بدون دمیار بر عملکرد ریه در بیماران مزمن انسدادی ریه: کارآزمایی بالینی تصادفی
Comparison the Effect of Salbutamol via Nebulizer, Spray with and without Spacer on Pulmonary Function in Chronic Obstructive Pulmonary Disease: Randomized Clinical Trial
آموزش پرستاری
Nursing Education
پژوهشي-کامل
Research(Original)
<span style="font-size:12pt"><span style="line-height:82%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="FA" style="line-height:82%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.1pt">سابقه</span></span></span></span><span lang="AR-SA" style="line-height:82%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.1pt"> و هدف:</span></span></span></span> <span lang="AR-SA" style="line-height:82%"><span style="font-family:"B Zar""><span style="color:black">بیماری مزمن انسدادی ریه شیوع بالایی در جامعه جهانی دارد و تعداد زیادی از مبتلایان از اسپری</span></span></span><span lang="AR-SA" style="line-height:82%"><span style="font-family:"B Zar""><span style="color:black">های استنشاقی استفاده می</span><span style="color:black">کنند. با توجه به این</span><span style="color:black">که انتخاب مناسب ترین روش برای رساندن داروی استنشاقی در کنترل بیماری مزمن انسدادی ریه به اندازه داروی انتخابی مهم است مطالعه</span></span></span> <span lang="AR-SA" style="line-height:82%"><span style="font-family:"B Zar""><span style="color:black">حاضر</span></span></span> <span lang="AR-SA" style="line-height:82%"><span style="font-family:"B Zar""><span style="color:black">به</span></span></span> <span lang="AR-SA" style="line-height:82%"><span style="font-family:"B Zar""><span style="color:black">منظور</span></span></span> <span lang="AR-SA" style="line-height:82%"><span style="font-family:"B Zar""><span style="color:black">مقایسه</span></span></span> <span lang="AR-SA" style="line-height:82%"><span style="font-family:"B Zar""><span style="color:black">اثر</span></span></span> <span lang="AR-SA" style="line-height:82%"><span style="font-family:"B Zar""><span style="color:black">سالبوتامول</span></span></span> <span lang="AR-SA" style="line-height:82%"><span style="font-family:"B Zar""><span style="color:black">از طریق نبولایزر و</span></span></span> <span lang="AR-SA" style="line-height:82%"><span style="font-family:"B Zar""><span style="color:black">اسپری با و بدون دمیار بر عملکرد ریه در بیماران مزمن انسدادی ریه طراحی شده است</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:82%"><span style="color:black">.</span></span></span><span lang="FA" style="line-height:82%"><span style="font-family:"B Zar""><span style="color:#0e101a"></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:82%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="AR-SA" style="line-height:82%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.1pt">مواد و روش</span></span></span></span><span lang="FA" style="line-height:82%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.1pt"></span></span></span></span><span lang="AR-SA" style="line-height:82%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.1pt">ها:</span></span></span></span> <span lang="AR-SA" style="line-height:82%"><span style="font-family:"B Zar""><span style="color:black">این کارآزمایی بالینی تصادفی بر روی 66 بیمار مبتلا به بیماری مزمن انسدادی ریه بستری در بیمارستان شهداء قاین در سال 1399 انجام شد. واحد های پژوهش با لحاظ معیارهای ورود به روش تصادفی به سه گروه نبولایزر و اسپری با و بدون دمیار تخصیص یافتند پس</span></span></span><span lang="AR-SA" style="line-height:82%"><span style="font-family:"B Zar""> از <span style="color:black">ورود داده</span><span style="color:black">ها تجزیه تحلیل با استفاده از نرم</span><span style="color:black">افزار </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:82%"><span style="color:black">SPSS</span></span></span><span style="line-height:82%"><span style="font-family:"B Zar""><span style="color:black"> نسخه ،23و آزمون های آماری کای اسکوئر،کروسال والیس،</span></span></span> <span dir="LTR" style="font-size:10.0pt"><span style="line-height:82%"><span style="color:black">ANOVA</span></span></span><span lang="AR-SA" style="line-height:82%"><span style="font-family:"B Zar""><span style="color:black"> و اندازه</span></span></span><span lang="AR-SA" style="line-height:82%"><span style="font-family:"B Zar""><span style="color:black">گیری مکرر انجام شد.</span></span></span><span lang="FA" style="line-height:82%"><span style="font-family:"B Zar""><span style="color:black"></span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:82%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="AR-SA" style="line-height:82%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.2pt">یافته</span></span></span></span><span lang="FA" style="line-height:82%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt"></span></span></span></span><span lang="AR-SA" style="line-height:82%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.2pt">ها:</span></span></span></span> <span lang="AR-SA" style="line-height:82%"><span style="font-family:"B Zar""><span style="color:black">بین سه گروه از نظر مشخصات جمعیت شناختی و اطلاعات مربوط به بیماری تفاوت معنیداری وجود نداشت(0/05</span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:82%"><span style="font-family:"B Zar""><span style="color:black"><</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:82%"><span style="color:black">P</span></span></span><span lang="AR-SA" style="line-height:82%"><span style="font-family:"B Zar""><span style="color:black">) میانگین شاخص های تنفسی ازجمله ظرفیت حیاتی اجباری، حجم بازدمی اجباری در ثانیه اول و نسبت حجم بازدمی اجباری در ثانیه اول به ظرفیت حیاتی اجباری در گروه اسپری با دمیار وگروه نبولایزر بهصورت معنیداری بیش</span></span></span><span lang="FA" style="line-height:82%"><span style="font-family:"B Zar""><span style="color:black"></span></span></span><span lang="AR-SA" style="line-height:82%"><span style="font-family:"B Zar""><span style="color:black">تر از گروه اسپری تنها بود(0/05</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:82%"><span style="color:black">P<</span></span></span><span lang="AR-SA" style="line-height:82%"><span style="font-family:"B Zar""><span style="color:black">). اما میانگین این شاخص</span></span></span><span lang="AR-SA" style="line-height:82%"><span style="font-family:"B Zar""><span style="color:black">ها در گروه اسپری با دمیار وگروه نبولایزر در مقایسه با هم تفاوت معنی</span><span style="color:black">داری نداشت.</span></span></span><span lang="FA" style="line-height:82%"><span style="font-family:"B Zar""><span style="color:black"></span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:82%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="AR-SA" style="line-height:82%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.2pt">استنتاج:</span></span></span></span> <span lang="AR-SA" style="line-height:82%"><span style="font-family:"B Zar""><span style="color:black">نتایج حاصل از این مطالعه نشان داد که در بیماران مزمن انسدادی ریه، استنشاق سالبوتامول در دو روش اسپری با دمیار و نبولایزر تاثیر بالاتری، بر شاخصهای عملکردی ریه بیماران نسبت به اسپری به تنهایی دارد بنابراین توصیه می شود جهت داروهایی استنشاقی، از دمیار یا نبولایزر استفاده شوند.</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:82%"><span style="color:black"></span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:82%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="AR-SA" style="font-size:7.0pt"><span style="line-height:82%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt"></span></span></span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:85%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="FA" style="font-size:10.0pt"><span style="line-height:85%"><span style="font-family:"B Zar"">شماره ثبت کارآزمایی بالینی : 1</span></span></span><span dir="LTR" style="font-size:8.0pt"><span style="line-height:85%">N</span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:85%"><span style="font-family:"B Zar"">20200228046634</span></span></span><span dir="LTR" style="font-size:8.0pt"><span style="line-height:85%">IRCT</span></span><b><i><span lang="FA" style="font-size:10.0pt"><span style="line-height:85%"><span style="font-family:"2 Davat""></span></span></span></i></b></span></span></span></span></span><br>
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<span style="font-size:12pt"><span style="line-height:130%"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:10.0pt"><span style="line-height:130%"><span style="font-family:"Arial","sans-serif""><span style="letter-spacing:-.2pt">Background and purpose:</span></span></span></span></b> <span lang="EN" style="font-size:10.0pt"><span style="line-height:130%">Chronic obstructive pulmonary disease has a high prevalence in the world community and the majority of sufferers use inhalation sprays. There is a remarkable consensus that the choose the most appropriate method to deliver inhaled medicine in the control of chronic obstructive pulmonary disease is as important as the selected drug. Therefore, the purpose of the present study was to compare the effect of salbutamol through spray, spacer and the nebulizer on lung function in chronic obstructive pulmonary disease patients</span></span><span style="font-size:10.0pt"><span style="line-height:130%">.</span></span><span style="font-size:10.0pt"><span style="line-height:130%"></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:130%"><span style="text-autospace:none"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:10.0pt"><span style="line-height:130%"><span style="font-family:"Arial","sans-serif"">Materials and methods:</span></span></span></b><b> </b><span lang="EN" style="font-size:10.0pt"><span style="line-height:130%">This randomized clinical trial was conducted on 66 patients with chronic obstructive pulmonary disease hospitalized in Shahada Qain Hospital in 2019. Research units were randomly assigned to spray, spacer, and nebulizer groups based on the inclusion criteria. After entering the data into SPSS software version 23, chi-square, Crosal-Wallis, ANOVA and repeated measurement statistical tests were used to analyze the data</span></span><span lang="EN" style="font-size:10.0pt"><span style="line-height:130%">.</span></span><span style="font-size:10.0pt"><span style="line-height:130%"></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:130%"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:10.0pt"><span style="line-height:130%"><span style="font-family:"Arial","sans-serif"">Results:</span></span></span></b><b> </b><span lang="EN" style="font-size:10.0pt"><span style="line-height:130%">There was no significant difference between the three groups in terms of demographics <span style="letter-spacing:-.2pt">and information related to the disease (P>0.05). The average respiratory indices including FVC, FEV1, SPO2,</span> FEV1FVC and respiratory rate after the intervention in the spray group with spacer and the nebulizer <span style="letter-spacing:-.2pt">group were significantly higher than the spray alone group (P<0.05). In addition, the average of these indices</span> <span style="letter-spacing:-.2pt">after the intervention, there was </span></span></span><span lang="EN" style="font-size:9.5pt"><span style="line-height:130%"><span style="letter-spacing:-.2pt">no significant difference in the spray</span></span></span><span lang="EN" style="font-size:10.0pt"><span style="line-height:130%"><span style="letter-spacing:-.2pt"> group with spacer and the nebulizer group</span></span></span><span lang="EN" style="font-size:10.0pt"><span style="line-height:130%"><span style="letter-spacing:-.2pt">.</span></span></span><span lang="EN" style="font-size:10.0pt"><span style="line-height:130%"></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:130%"><span style="vertical-align:top"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:10.0pt"><span style="line-height:130%"><span style="font-family:"Arial","sans-serif"">Conclusion:</span></span></span></b> <span style="font-size:10.0pt"><span style="line-height:130%">The results of this study revealed that inhalation of salbutamol in patients with chronic obstructive pulmonary disease has a higher impact on lung functional indices in both spray with spacer and nebulizer methods compared to spray alone. Therefore, it is recommended to use a spacer or nebulizer for inhalable medications</span></span><span style="font-size:10.0pt"><span style="line-height:130%">.<i><span style="color:black"></span></i></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="tab-stops:121.45pt"><span style="font-family:"Times New Roman","serif""><b><i><span style="font-size:6.0pt"><span style="color:black"></span></span></i></b></span></span></span><br>
<span style="font-size:8.0pt"><span style="font-family:"Times New Roman","serif""><span style="letter-spacing:-.1pt"> (Clinical Trials Registry Number: </span></span></span><span style="font-size:8.0pt"><span style="font-family:"Times New Roman","serif""><span style="letter-spacing:-.1pt">IRCT20200228046634N1</span></span></span><span style="font-size:8.0pt"><span style="font-family:"Times New Roman","serif""><span style="letter-spacing:-.1pt">)</span></span></span>
بیماری مزمن انسدادی ریه, اسپیرومتری, نبولایزر, اسپری, دمیار
chronic obstructive pulmonary disease, spirometry, nebulizer, spray, demiyar
71
79
http://jmums.mazums.ac.ir/browse.php?a_code=A-10-9286-4&slc_lang=fa&sid=1
Kokab
Basiri Moghadam
کوکب
بصیری مقدم
K.basiri@gmu.ac.ir