盐酸氨溴索与庆大霉素联合雾化吸入对食管癌术后呼吸功能恢复的影响  

Impact of inhalation of ambroxol hydrochloride and gentamicin on restoration of respiratory function after surgical treatment for esophageal carcinoma

作　　者：米丽丽[1] 王伟[2] 张国亮[1] 朱希燕[1] 何艳凛[1] 王瑞[1] 

机构地区：[1]河北医科大学第四医院胸心外科,石家庄市050011 [2]河北省成安县人民医院外科,056700

出　　处：《实用医学杂志》2012年第21期3621-3623,共3页The Journal of Practical Medicine

基　　金：河北省科技支撑计划课题项目(编号:09276177);河北省普通高等学校强势特色学科肿瘤学建设经费资助项目(编号:冀教高[2005]52号)

摘　　要：目的:探讨盐酸氨溴索与庆大霉素联合雾化吸入对食管癌患者术后呼吸功能恢复的影响。方法:将120例食管癌切除术患者,随机分为对照组(A组)、庆大霉素组(B组)、盐酸氨溴索组(C组)和联合用药组(D组),分别给予生理盐水20mL,生理盐水20mL+庆大霉素8万单位,生理盐水20mL+盐酸氨溴索30mg和生理盐水20mL+庆大霉素8万单位+盐酸氨溴索30mg于手术后开始雾化吸入,4次/d。采用改进的Borg量表进行主观呼吸功能障碍程度评定,观察患者术后第1、3和5天的主观呼吸功能障碍程度及肺不张、肺炎的发生情况。结果:术后第1天B、C和D组患者主观呼吸功能障碍程度与A组无明显差异(χ2=3.16,P=0.37),第3天改善明显(χ2=32.45,P<0.01),B组(χ2=10.0,P=0.002)、C组(χ2=15.6,P<0.01)和D组(χ2=28.0,P<0.01)均较A组明显改善,但B组与C组比较无明显差异(χ2=0.37,P=0.54),而D组与B组(χ2=7.5,P<0.01)和C组(χ2=4.5,P=0.03)比较呼吸功能障碍程度明显减轻,术后第5天呼吸障碍程度统计结果与第3天相似。术后发生肺部并发症17例(14.17%),其中A组8例(26.7%)、B组4例(13.3%)、C组4例(13.3%),D组1例(3.3%),D组较A组发生肺部并发症明显减少(χ2=6.4,P=0.01)。结论:联合应用盐酸氨溴索与庆大霉素雾化吸入可以明显改善食管癌术后患者的呼吸功能,减少肺部并发症的发生,方法简便,易于临床推广。[Abstrct] Objective To explore the impact of inhalation of ambroxol hydrochloride and gentamicin on restoration of respiratory function after surgical treatment for esophageal carcinoma. Methods 120 patients who had undergone surgical resection for esophageal carcinoma were randomly assigned to receive inhalatin of NS of 20 mL （control group, group A）, NS of 20 mL plus gentamicin of 80,000 unit （gentamiein group, group B）, NS of 20 mL plus ambroxol hydrochloride of 30 mg （ambroxol hydrochloride group, group C）, or NS of 20 mL plus gentamicin of 80,000 unit and ambroxol hydrochloride of 30 mg （combination group, group D） four times daily after surgery. The modified Borg scale was used to measure levels of subjective respiratory dysfunction on days 1, 3 and 5 after surgery and incidence of pulmonary atelectasis and pneumonia were observed. Results As compared with group A, level of subjective respiratory dysfunction did not differed significantly in groups B, C, and D on day 1 （X2 = 3.16, P = 0.37） ; there were significant differences between group B and group A （X2 = 10.0, P = 0.002）, group C and group A （X2 = 15.6, P 〈 0.01）, and group D and group A （X2 = 28.0, P 〈 0.01） on day 3. Level of respiratory dysfunction differed significantly between group D and groups B and C （X2 = 7.5, P 〈 0.01 and X2 = 4.5, P = 0.03）. Level of respiratory dysfunction on day 5 was similar to that on day 3. Postoperative pulmonary complications occurred in 17 patients （14.17%）, 8 of which （26.7%） were in group A, 4 （13.3%） in group B, 4 （13.3%） in group C, and 1 （3.3%） in group D; and the rate of pulmonary complications was obviously lower in group D than in group A （X2 = 6.4, P= 0.01 ）. Conclusions Combined inhalation of ambroxol hydrochloride and gentamycin can markedly improve respiratory function and reduce incidence of pulmonary complications in patients undergoing surgical resection for esophageal carcinoma. This combined inhalation therapy is simple and easy to po

关 键 词：食管肿瘤 手术 盐酸氨溴索 雾化吸入 呼吸功能 

分 类 号：R735.1[医药卫生—肿瘤]