盐酸氨溴索在老年肺癌吸烟患者围术期的应用  

Perioperative application of ambroxolin elderly smoking patients undergoing lung cancer operation

作　　者：王新[1] 王雷[1] 张浩[1] 王化勇[1] 

机构地区：[1]江苏徐州市中心医院胸外科,221009

出　　处：《中华老年医学杂志》2014年第10期1078-1080,共3页Chinese Journal of Geriatrics

摘　　要：目的 观察术前应用盐酸氨溴索对老年肺癌吸烟患者围术期肺保护的临床疗效。 方法 将220例老年长期吸烟且需开胸行肺叶切除的患者随机分为两组,分别于术前5d和术后第1天开始给予盐酸氨溴索治疗,比较两组患者术后咳痰难易程度、痰液性质、抗生素应用时间、发生肺部并发症和药物不良反应情况. 结果 手术后第3天和第7天,患者在咳痰难易程度、痰液性质方面试验组较对照组有改善（x2 =6.77、6.08、8.12、12.61,P=0.034、0.049、0.017、0.002）。试验组患者抗生素平均使用时间为（5.92±0.72）d,少于对照组（7.04±0.87）d（t=10.33,P=0.000）;术后试验组患者肺部感染和肺不张发生率分别为19.6％（22/112）、6.3％（7/112）,低于对照组33.3％（36/108）、16.7％（18/108）（x2=5.31、5.92,P=0.021、0.015）.两组患者除均有2例出现轻度恶心呕吐,无其他不良反应,差异无统计学意义（x2=0.22,P=1.000）。 结论 术前应用盐酸氨溴索可有效改善老年且长期吸烟肺癌患者术后咳痰能力、减少肺部并发症、缩短术后抗生素应用时间,值得临床推广。Objective To investigate the effect of perioperative application of ambroxol in elderly smoking patients undergoing lung cancer operation.Methods 220 long time smoker undergoing pulmonary lobectomy were randomized into two groups：the intervention group （n=112） and the control group （n =108）.The intervention group received ambroxol injection 30 mg intravenously,thrice daily from five days before the surgery.The control group was given ambroxol injection 30 mg intravenously,thrice daily from one day after the surgery.The difficulty in expectoration,the nature of the sputum and the duration of antibiotic use were recorded.The postoperative lung complications and the adverse reactions of ambroxol were observed.Results There were significant differences in improvements of expectoration and the nature of the sputum on the third and seventh after operation between the intervention and control groups（x2 =6.77,6.08,8.12,12.61,P=0.034,0.049,0.017,0.002）.After the surgery,the duration of antibiotic use was less in the intervention group than in the control group [（5.92 ± 0.72） d vs.（7.04 ± 0.87） d,t =10.33,P=0.000].The incidences of lung infections and atelectasis after the surgery were lower in the intervention group than in the control group [19.6% （22/112） vs.33.3% （36/108）,6.3% （7/112） vs.16.7% （18/108）,x2 =5.31,5.92,P=0.021,0.015].In both groups,two patients had mild nausea and vomiting （x2 =0.22,P=1.000）.No other common adverse reactions of ambroxol were observed in the two groups.Conclusions Perioperative application of ambroxol can decrease the sputum viscosity,make expectoration easier and reduce the occurrence of postoperative lung complications and the duration of antibiotic use.It is worth wide application in clinical practice.

关 键 词：肺肿瘤 氨溴索 

分 类 号：R734.2[医药卫生—肿瘤]