术前应用氨溴索对左心室舒张功能不全老年患者开胸术后疗效研究  

Study of curative effect on preoperative use of ambroxol in elderly patients with left ventricular diastolic dysfunction after thoracic surgeries

作　　者：韩小磊[1] 张鹏[1] 李新[1] 陈渊[1] 

机构地区：[1]天津医科大学总医院心胸外科,天津300052

出　　处：《天津医科大学学报》2016年第2期160-163,167,共5页Journal of Tianjin Medical University

摘　　要：目的:探讨术前应用氨溴索对左心室舒张功能不全老年患者开胸术后心肺功能的疗效。方法:收集入院需行开胸手术的老年患者88例,患者均合并左心室舒张功能不全,6 min步行试验步行距离>300 m,随机分为试验组与对照组,试验组术前应用氨溴索治疗,对照组应用安慰剂。术前3 d及术后3、8 d行静态肺功能、超声心动及组织多普勒检查,术后3 d检测血清B型脑钠肽(BNP)、C反应蛋白(CRP)、降钙素原(PCT),监测患者生命体征及术后心肺并发症发生情况,对上述指标进行分析比较。结果:试验组术后肺功能及心功能均优于对照组,P<0.05。患者术后生命体征及动脉血气分析提示试验组基础状态比对照组更稳定,P<0.05。BNP、CRP、PCT检验指标低于对照组,P<0.05。试验组患者术后肺感染、肺不张、心衰、心律失常等心肺并发症的发生率低于对照组,P<0.05。结论:患者术前应用氨溴索可以减少手术对患者的创伤,改善患者术后心肺功能,减少患者心肺并发症发生率,有助于患者更好的应对手术,减少不良预后。Objective： To investigate curative effect of preoperative use of ambroxol in elderly patients with left ventricular diastolic dysfunction after thoracic surgeries. Methods： Eighty eight cases of elderly patients in hospital were collected,who all had left ventricular diastolic dysfunction, but whose six minutes walking distance300 m. The patients were divided into experimental group and control group,ambroxol were used preoperation, while placebo were used in the control group. Static pulmonary function, Doppler ultrasound, C reactive protein（CRP）, brain natriuretic peptide（BNP）, procalcitonin（PCT）were detected 3 days before and after the operation, 8 days after operation. Vital signs and complications of heart and lung postoperation were also monitored and analyzed. Results： The lung function and heart function in the experimental group were better than those in the control group（P〈0.05）. The vital signs and arterial blood gas of the patients in the experimental group after the thoracic surgeries were more stable than those in the control group（P〈0.05）. Laboratorial index includes BNP, CRP, PCT of the experimental group was lower than that in the control group（P〈0.05）. The incidence of pulmonary infection,pulmonary atelectasis, heart failure, arrhythmia in the experimental group after the thoracic surgeries were lower than that in the control group（P〈0.05）. Conclusion： Preoperative use of ambroxol can reduce the surgical trauma, improve heart and lung function in patients after the thoracic surgeries, as well as decrease the incidence of lung and heart complications. It also can help patients better adapt to the operation, leading to lower adverse effect.

关 键 词：左心室舒张功能不全 开胸手术 氨溴索 

分 类 号：R655[医药卫生—外科学]