雾化吸入盐酸戊乙奎醚在尘肺患者大容量全肺灌洗术后的应用研究  

Application of aerosol inhalation of penehyclidine hydrochloride after large volume whole lung lavage in pneumoconiosis patients

作　　者：王润丰[1] 方申存[2] 周本昊[1] 夏梦[3] 王研[1] 

机构地区：[1]南京市胸科医院重症医学科,江苏南京210029 [2]南京市胸科医院呼吸科,江苏南京210029 [3]南京市胸科医院麻醉科,江苏南京210029

出　　处：《临床肺科杂志》2016年第11期2006-2008,共3页Journal of Clinical Pulmonary Medicine

基　　金：南京市科技计划项目基金(No 201402038)

摘　　要：目的评价雾化吸入盐酸戊乙奎醚在尘肺患者大容量全肺灌洗术后的应用价值。方法选取分期进行单侧大容量全肺灌洗术(WLL)后带管入ICU患者50例,随机分为对照组(C组)与治疗组(PHC组)各25例,术后入室即刻起给予雾化吸入,每隔8h一次,每次20min,C组雾化吸入生理盐水5m L+二羟丙茶碱0.25g,PHC组雾化吸入生理盐水5m L+盐酸戊乙奎醚1.0mg,分别测定两组在入室时,入室后10min、30min、60min、120min、拔管时患者呼吸力学指标变化,以及拔管时间,低氧及再次机械通气发生率。结果与对照组相比较,治疗组雾化吸入后各时间点气道峰压、气道阻力明显降低、肺顺应性明显升高(P<0.05),拔管时间有所提前(P<0.05)。术后出现低氧、再次机械通气例数减少(P<0.05)。结论雾化吸入戊乙奎醚可有效改善患者WLL后呼吸力学指标,减少插管时间,降低术后并发症发生率,有利于术后恢复。Objective To evaluate the application value of aerosol inhalation of penehyclidine hydrochloride （ PHC） after large volume whole lung lavage in pneumoconiosis patients. Methods 50 ventilated patients in ICU af-ter massive whole-lung lavage were randomly divided into 2 groups （ n=25 each）： the control group and the PHC group. They were immediately given atomization inhalation, 8 hours every time, every time 20 min. The control group inhaled diprophylline 0. 25g and the PHC group inhaled PHC 1. 0g. Respiratory mechanics index, extubation time and the incidence of hypoxemia and airway spasm were measured before inhalation and at 10min, 30min, 60min and 120 min after inhalation and during extubation. Extubation time, the incidence of low oxygen and mechanical ventila-tion again were recorded. Results Compared with the control group, their airway peak pressure and airway resist-ance decreased significantly at each time point in the PHC group, and dynamic lung compliance increased significant-ly. Extubation time was shorter and the incidence of hypoxemia and mechanical ventilation again were lower in the PHC group than in the control group. Conclusion PHC can improve their lung compliance and reduce extubation time and postoperative complications, which is helpful to patients’ recovery.

关 键 词：戊乙奎醚 尘肺 大容量全肺灌洗术 雾化吸入 

分 类 号：R135.2[医药卫生—劳动卫生]