大剂量盐酸氨溴索联合纤支镜灌洗对老年重症肺炎患者氧合指数血清CRP PCT水平的影响  

Effects of High-Dose Ambroxol Hydrochloride Combined with Fiberbronchoscope Lavage on Oxygenation Index Serum CRP and PCT Levels in Elderly Patients with Severe Pneumonia

作　　者：陈绵聪 陈伟[1] 林秀山 符名勇 CHEN Miancong;CHEN Wei;LIN Xiushan(The First Affiliated Hospital of Hainan Medical College, Hainan Haikou 570102, China)

机构地区：[1]海南医学院第一附属医院,海南海口570102 [2]海南省海口市第四人民医院重症医学科,海南海口571100

出　　处：《河北医学》2020年第9期1434-1438,共5页Hebei Medicine

基　　金：海南省科技厅课题,(编号:ZY201426)。

摘　　要：目的:探究大剂量盐酸氨溴索+纤维支气管镜(简称“纤支镜”)在老年重症肺炎(SP)患者中的应用价值。方法:计算机随机数字法简单随机分组将本院2016年7月至2019年7月收治的90例老年SP患者分为单一组与联合组,分别给予大剂量盐酸氨溴索、大剂量盐酸氨溴索+纤支镜治疗。评价两组疗效及相关指标。结果:联合组治疗总有效率97.78%,显著高于单一组的82.22%(P<0.05);对比治疗前,两组治疗后动脉氧分压(PaO2)、血氧饱和度(SaO2)、氧合指数均显著上升(P<0.05),C反应蛋白(CRP)、降钙素原(PCT)水平均显著下降(P<0.05),且联合组上升或下降幅度明显大于单一组(P<0.05);联合组治疗后APACHEⅡ评分、机械通气、肺部症状消失时间与重症监护病房(ICU)入住时间均显著小于单一组(P<0.05);联合组院内多器官功能衰竭(MOF)发生率及28d死亡率分别为15.56%、6.67%,均显著低于单一组的37.78%、24.44%(P<0.05)。结论:大剂量盐酸氨溴索+纤支镜治疗老年SP疗效较好,能明显改善患者氧合指数,减轻病情及炎症,减少病死率。Objective:To explore the fiberbronchoscope value of high-dose ambroxol hydrochloride combined with fiberbronchoscope lavage in elderly patients with severe pneumonia(SP).Methods:90 elderly patients with SP treated in the hospital between July 2016 and July 2019 were divided into the single medication group and the combined medication group with the computer-assisted random number method.They were treated with high-dose ambroxol hydrochloride and high-dose ambroxol hydrochloride combined with bronchoscopic lavage,respectively.The curative effect and related indicators in the two groups were evaluated.Results:The total effective rate of treatment in the combined medication group(97.78%)was significantly higher than that in the single medication group(82.22%)(P<0.05).The arterial partial pressure of oxygen(PaO2),degree of blood oxygen saturation(SaO2)and oxygenation indexes in the two groups increased significantly after treatment(P<0.05),while levels of C-reactive protein(CRP)and procalcitonin(PCT)decreased significantly(P<0.05).The increase or decrease in the combined medication group was significantly greater than that in the single medication group(P<0.05).The APACHEⅡscore,duration of mechanical ventilation,lung symptom disappearance time and length of intensive care unit(ICU)stay of the combined medication group after treatment were significantly lower or shorter than those of the single medication group(P<0.05).The incidence rate of multiple organ failure(MOF)and 28-day mortality rate in the combined medication group(15.56%and 6.67%)were significantly lower than those in the single medication group(37.78%and 24.44%)(P<0.05).Conclusion:High-dose ambroxol hydrochloride combined with bronchoscopic lavage is effective in the treatment of elderly SP.It can obviously improve the oxygenation index,improve the condition,and reduce inflammation and mortality rate.

关 键 词：氨溴索 纤维支气管镜 老年重症肺炎 氧合指数 

分 类 号：R47[医药卫生—护理学]