氨溴索联合经鼻高流量湿化氧疗治疗老年重症肺炎合并呼吸衰竭的临床研究  

Clinical study of ambroxol combined with nasal high-flow humidified oxygen therapy in the treatment of senile severe pneumonia complicated with respiratory failure

作　　者：徐秋燕[1] 劳永光[1] XU Qiu-yan;LAO Yong-guang(Surgical Intensive Care Unit,Zhanjiang Central People's Hospital,Zhanjiang 524000,China)

机构地区：[1]湛江中心人民医院外科重症监护室,广东湛江524000

出　　处：《中国处方药》2022年第9期131-133,共3页Journal of China Prescription Drug

基　　金：湛江市非资助科技攻关专题(2020B101)。

摘　　要：目的探讨氨溴索联合经鼻高流量湿化氧疗(HFNC)治疗老年重症肺炎合并呼吸衰竭的临床疗效。方法选取2020年5月~2021年12月收治的200例老年重症肺炎合并呼吸衰竭患者,全部患者均接受抗炎、化痰、平喘等常规治疗,随机数字表法分为两组各100例。试验组以氨溴索联合HFNC治疗;对照组以氨溴索联合无创正压通气治疗。比较观察两组干预前后不同时点血流动力学指标HR与MAP、炎症指标WBC、CRP与PCT、APACHE-Ⅱ评分与SOFA评分,评价两组疗效,统计两组ICU住院时间、住院费用与90 d生存率。结果试验组治疗后1 h、6 h、12 h、24 h、3 d HR与MAP低于对照组,差异有统计学意义(P<0.05)。两组治疗后WBC、CRP与PCT水平差异无统计学意义(P>0.05)。试验组治疗后APACHE-Ⅱ与SOFA评分均低于对照组,ICU住院时间短于对照组,住院费用少于对照组,治疗总有效率与90 d生存率高于对照组,差异有统计学意义(P<0.05)。结论氨溴索联合HFNC治疗老年重症肺炎合并呼吸衰竭效果确切,可以早期改善患者血流动力学,临床疗效显著。Objective To explore the clinical efficacy of ambroxol combined with nasal high-flow humidified oxygen therapy(HFNC)in the treatment of elderly patients with severe pneumonia complicated with respiratory failure.Methods Selected 200 elderly patients with severe pneumonia complicated by respiratory failure admitted to our department from May 2020 to December 2021.All patients received conventional treatments such as anti-inflammatory,phlegm-relieving,and anti-asthma.They were randomly divided into two groups with 100 patients in each group.The experimental group was treated with ambroxol combined with HFNC;the control group was treated with ambroxol combined with non-invasive positive pressure ventilation.The hemodynamic indexes HR and MAP,inflammatory indexes WBC,CRP and PCT,APACHE-Ⅱ score and SOFA score at different time points before and after the intervention were compared between the two groups,and the curative effect,the time of living in ICU,hospitalization costs and 90-day survival rate of the two groups was evaluated.Results The HR and MAP of the experimental group at 1 h,6 h,12 h,24 h,and 3 d after treatment were lower than those of the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the levels of WBC,CRP and PCT between the two groups after treatment(P>0.05).After treatment,the APACHE-Ⅱ and SOFA scores of the experimental group were lower than those of the control group,the ICU length of stay was shorter than that of the control group,and the hospitalization cost was lower than that of the control group(P<0.05).Conclusion Ambroxol combined with HFNC is effective in the treatment of elderly patients with severe pneumonia complicated with respiratory failure.

关 键 词：重症肺炎 呼吸衰竭 氨溴索 经鼻高流量湿化氧疗 

分 类 号：R563.1[医药卫生—呼吸系统] R563.8[医药卫生—内科学]