氨溴索联合异丙托溴铵治疗老年患者呼吸机相关性肺炎的疗效  

Clinical curative effect of ipratropium bromide in combination with ambroxol hydrochoride on ventilator- associated pneumonia in elderly patients

作　　者：刘毅梅[1] 王俊义[1] 陈渊[1] 李新[1] 吕朋[1] 张鹏[1] 

机构地区：[1]天津医科大学总医院心胸外科,300052

出　　处：《中华老年医学杂志》2015年第8期866-868,共3页Chinese Journal of Geriatrics

摘　　要：目的探讨盐酸氨溴索联合异丙托溴铵治疗老年患者呼吸机相关性肺炎（VAP）的疗效。方法收集2013年1月至2014年11月老年VAP患者46例，随机法分为试验组23例和对照组23例。两组患者在相同的对症处理和抗感染基础上，同时给予异丙托溴铵0．5mg／次，加入5ml生理盐水稀释后经呼吸机雾化吸入，3次／d；试验组则联合盐酸氨溴索静脉注射，30rag／次，3次／d，比较两组患者临床治疗总有效率、机械通气时间、气管镜吸痰次数和白细胞计数。结果试验组患者临床治疗总有效率91．0％（21／23），较对照组74．0％（17／23）高，差异有统计学意义（x2=11．310，p=0．002）；试验组患者机械通气时间、支气管镜吸痰次数和治疗后白细胞计数分别为（8．2±1.5）d、（3．5±0．3）次和（9．5±2．3）×10^9／L，均优于对照组（13．7±3．1）d、（6．7±1．2）次和（14．2±2．7）×10^9／L，差异有统计学意义（t=17．510、2．750、3．810，P=0．000、0．001、0．001）。结论较单一用药，盐酸氨溴索联合异丙托溴铵可以改善老年VAP患者气道湿化功能，促进纤毛输送分泌物，缩短机械通气时间以及提高VAP的治愈率。Objective To investigate the clinical curative effect of ipratropium bromide in combination with ambroxol hydrochloride （mucosolvan） on ventilator associated pneumonia （VAP） in elderly patients. Methods From Jan 2013 to Nov 2014, a total of 46 elderly patients with VAP in our hospital were treated with ipratropium bromide 0.5 mg diluted in 5 ml saline by inhalation with ventilator, and mucosolvan 30 mg by intravenous iniection, 3 times/d （treatment group, n= 23）, and treated with ipratropium bromide 0.5 mg diluted in 5 ml saline by inhalation with ventilator, 3 times/d （control group, n=23）. Total clinical effective rate, ventilating time, number of sputum suction by fibre bronehoscope and white cell count were compared between the two groups. Results The total clinical effective rate was higher in treatment group than in the control group [91%0 （21/23） vs. 740/00 （17/23）, X2 =11. 310, P=0. 002]. The indicators of ventilating time, number of sputum suction by fibre bronchoseope and white cell count were improved in treatment group as compared with control group [（8.2±1.5）d vs （13.7±3.1）d, （3.5±0.3） vs. （6.7±1.2）, （9.5±2.3） ×109/L vs. （14.2±2.7）×10g/L, t=17.510, 2.750, 3.810, respectively, P=0.000, 0.001, 0.001]. Conclusions Compared with single-drug treatment, ipratropium bromide in combination with ambroxol hydrochloride （mucosolvan） could improve airway humidification, promote cilium to clean secreta, shorten the ventilating time and increase the curative rate of VAP in elderly patients.

关 键 词：肺炎 呼吸机相关性 氨溴索 

分 类 号：R563.1[医药卫生—呼吸系统]