N-乙酰半胱氨酸联合硫酸特布他林雾化液经纤支镜肺泡灌洗治疗重症肺部感染并肺不张患者的临床疗效  

Clinical efficacy of N-acetylcysteine combined with terbutaline sulfate aerosol solution in the treatment of severe pulmonary infection with atelectasis by fiberoptic bronchoscopy alveolar lavage

作　　者：万小雷 章柏平[1] 郭剑[1] WAN Xiaolei;ZHANG Beping;GUO Jian(Department of Emergency and Critical Medicine,Yingtan Medical Campus of the 908 Hospital of Joint Logistic Support Force of the People's Liberation Army,Yingtan,Jiangxi,335400,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇八医院鹰潭医疗区急诊与重症医学科,江西鹰潭335400

出　　处：《当代医学》2022年第26期100-103,共4页Contemporary Medicine

摘　　要：目的探讨N-乙酰半胱氨酸联合硫酸特布他林雾化液应用纤支镜肺泡灌洗治疗重症肺部感染并肺不张患者的临床疗效。方法选取2016年1月至2019年12月本院收治的113例重症肺部感染并肺不张患者作为研究对象,采用随机数字表法分为实验组(n=57)和对照组(n=56)。两组均给予纤维支气管镜吸痰治疗,对照组同时给予0.9%氯化钠溶液肺泡灌洗治疗,实验组同时给予N-乙酰半胱氨酸联合硫酸特布他林雾化液肺泡灌洗治疗。比较两组治疗前后血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、动脉血氧饱和度(SaO_(2))、pH值]、临床肺部感染评分(CPIS)、临床疗效及并发症发生情况。结果治疗后,实验组PaO_(2)、SaO_(2)均高于对照组,PaCO_(2)低于对照组,差异有统计学意义(P<0.05);治疗后,两组pH值比较差异无统计学意义。治疗后,两组CPIS均低于治疗前,且实验组低于对照组,差异有统计学意义(P<0.05)。实验组治疗总有效率为94.7%,明显高于对照组的80.7%,差异有统计学意义(P<0.05)。两组支气管痉挛、心律失常发生率比较差异无统计学意义。结论N-乙酰半胱氨酸联合硫酸特布他林雾化液经纤维支气管镜肺泡灌洗治疗重症肺部感染并肺不张效果显著,能更有效清除气道黏稠分泌物,改善肺叶复张及通气功能,减轻肺部感染情况,促进病灶吸收,加快患者恢复,还可有效减少支气管痉挛及心律失常的发生,值得临床推广应用。Objectives To explore the clinical efficacy of N-acetylcysteine combined with terbutaline sulphate aerosol solution in the treatment of patients with severe pulmonary infection with atelectasis by fiberoptic bronchoscopy alveolar lavage.Methods A total of 113 cases with severe pulmonary infection with atelectasis who were admitted to our hospital from January 2016 to December 2019 were selected as the research subjects,and they were divided into experimental group(n=57)and control group(n=56)according to random number table method.Both groups were treated with fiberoptic bronchoscopy alveolar lavage,the control group was simultaneously given 0.9%sodium chloride solution alveolar lavage treatment,the experimental group was simultaneously given N-acetylcysteine combined with terbutaline sulfate aerosol solution alveolar lavage treatment.The blood gas index(arterial partial pressure of oxygen[PaO_(2)],arterial partial pressure of carbon dioxide[PaCO_(2)],arterial oxygen saturation[SaO_(2)]and pH),clinical pulmonary infection score(CPIS)before and after treatment,and the clinical efficacy and complications were compared between two groups.Results After treatment,the PaO_(2)and SaO_(2)in the experimental group were higher than those in the control group,and the Pa-CO_(2)was lower than that in the control group(P<0.05);after treatment,there were no significant difference in pH between two groups.After treatment,the score of CPIS in the two groups were lower than before treatment,and the experimental group was lower than the control group(P<0.05).The total effective rate of the experimental group was 94.7%,which was significantly higher than 80.7%of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of bronchospasm and arrhythmia between the two groups.Conclusion N-acetylcysteine combined with terbutaline sulfate aerosol solution through fiberoptic bronchoscope alveolar lavage in the treatment of severe pulmonary infection with atelectasis has

关 键 词：重症肺部感染 肺不张 纤维支气管镜 肺泡灌洗 N-乙酰半胱氨酸 硫酸特布他林雾化液 

分 类 号：R563.1[医药卫生—呼吸系统]