大剂量氨溴索对ARDS合并机械通气相关肺炎的作用研究  

Effect of high dose ambroxol in the patients with ARDS and VAP

作　　者：金钧[1] 郭强[1] 王俊[1] 付建红[1] 黄芳[1] 徐华[1] 李娜[1] 杨新静[1] 

机构地区：[1]苏州大学附属第一医院急诊ICU,215006

出　　处：《临床肺科杂志》2008年第6期680-681,共2页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨大剂量氨溴索对ARDS合并机械通气相关肺炎的作用。方法选择2006年3月～2007年5月我院ICU确诊的30～70岁的ARDS并合并机械通气相关肺炎患者,分为A、B两组,A组(小剂量氨溴索组)15例,其中男9例,女6例,平均年龄(37.4±6.2)岁,应用小剂量组氨溴索2mg/kg/d。B组(大剂量氨溴索组)18例,其中男11例,女7例,平均年龄(42.1±8.7)岁,应用大剂量组氨溴索16mg/kg/d。实验观察持续7d。两组患者年龄、性别、基础疾病、营养状况、氧合指数(氧分压/氧浓度)、肺内分流值、急性生理功能与慢性健康状况评分、呼气末正压水平等的差异无统计学意义(P>0.05)。均由同一医师组治疗,且其它治疗方案基本相同。比较两组患者治疗前和治疗第7天的氧分压氧合指数、肺损伤评分、呼吸力学的差异。结果大剂量氨溴索组较小剂量氨溴索组的氧分压氧合指数上升、肺损伤评分降低、呼吸力学指标中气道峰压、气道阻力降低,肺顺应性升高。结论:大剂量氨溴索可能比小剂量氨溴索ARDS合并机械通气相关肺炎更具有保护作用。Objective To investigate the effect of high dose ambroxol on the patients with ARDS and VAP. Methods 33 patients with ARDS and ventilator-associated pneumonia（VAP） were enrolled in the study. They were divided randomly into 2 groups. Patients in group A were treated with ambroxol（ 2 mg/kg/d） , and those in group B received high dose ambroxol（ 16 mg/kg/d） for 7 consecutive days. The arterial blood samples were taken for blood gas and the parameters of respiratory mechanics were recorded before ambroxol infusion,7 days following the first infusion respectively. We monitored the changes of PaO2 , PaO2/FiO2 ,ALI score, PIP, RAW, and CL. Results The PaO2 , PaO2/FiO2 and CL of patients in group B with high dose ambroxol therapy were improved significantly （ P 〈 0.05 ）, which were much better than those in group A. But ALI score, PIP and RAW in group B were higher than those in group A （ P 〈 0. 05）. Conclusion High dose ambmxol may be more benefit for patient with ARDS and VAP patients than normal dose ambmxol.

关 键 词：机械通气相关肺炎 ARDS 氨溴索 大剂量 肺损伤评分 氧合指数 治疗方案 平均年龄 

分 类 号：R563.8[医药卫生—呼吸系统] R563.1[医药卫生—内科学]