大剂量盐酸氨溴索联合纤维支气管镜灌洗对老年重症肺炎的临床疗效研究  

Study on the clinical efficacy of high-dose ambroxol hydrochloride combined with fiberoptic bronchoscope lavage in the treatment of severe pneumonia in the elderly

作　　者：刘佳敏 LIU Jia-min(ICU,Quanzhou First Hospital,Quanzhou 362000,China)

机构地区：[1]福建省泉州市第一医院ICU,362000

出　　处：《中国现代药物应用》2024年第4期16-20,共5页Chinese Journal of Modern Drug Application

摘　　要：目的分析将大剂量盐酸氨溴索联合纤维支气管镜灌洗运用于老年重症肺炎患者中的临床价值。方法按照纳排标准筛查90例老年重症肺炎患者为研究对象,以郑骰子的方式随机区分为研究组和对照组,每组各45例患者,对照组患者接受大剂量盐酸氨溴索治疗,观组患者增加纤维支气管镜灌注治疗。比较两组患者临床治疗效果,治疗前后外周血炎症介质[C反应蛋白(CRP)、降钙素原(PCT)、白细胞计数(WBC)]水平,治疗前后血气指标[动脉血氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))]水平,临床症状改善时间,随访预后。结果观察组显效24例,有效20例,总有效率为97.78%(44/45),较对照组患者的86.67%(39/45)更高(P<0.05)。治疗前,两组患者外周血炎症介质CRP、PCT以及WBC水平组间比较差异无统计学意义(P>0.05);治疗后,两组患者外周血炎症介质CRP、PCT以及WBC水平均低于治疗前,且观察组显著低于对照组(P<0.05)。两组患者治疗后的PaO_(2)和SaO_(2)较治疗前升高(P<0.05);两组治疗前后组间比较差异无显著性(P>0.05)。观察组患者退热时间、咳嗽消失时间、肺部湿啰音消失时间以及胸痛消失时间分别为(1.23±0.21)、(1.63±0.51)、(2.36±0.51)、(2.98±0.12)d,显著短于对照组的(2.31±0.36)、(3.21±0.61)、(3.59±0.41)、(3.98±0.26)d(P<0.05)。观察组患者随访出现头晕乏力、恶心呕吐等不良反应,发生率为17.78%(8/45),与对照组的13.33%(6/45)比较差异无显著性(P>0.05)。结论将大剂量盐酸氨溴索联合纤维支气管镜灌洗运用于老年重症肺炎患者中的临床疗效确切,有助于改善患者机体炎症状态及血气指标,加快患者各项临床症状改善,且安全性与药物治疗相当,具有较好的推广应用价值。Objective To analyze the clinical value of high-dose ambroxol hydrochloride combined with fiberoptic bronchoscope lavage in the treatment of severe pneumonia in the elderly.Methods 90 elderly patients with severe pneumonia were screened according to the inclusion and exclusion criteria and were randomly divided into a control group and an observation group,with 45 patients in each group.The control group was treated with high-dose ambroxol hydrochloride,and the observation group was treated with fiberoptic bronchoscope lavage on the basis of the control group.Both groups were compared in terms of clinical effect,levels of peripheral inflammatory mediators[C-reactive protein(CRP),procalcitonin(PCT),white blood cell count(WBC)]before and after treatment,blood gas indicators[arterial pressure of partial oxygen(PaO_(2)),arterial oxygen saturation(SaO_(2))]before and after treatment,improvement of clinical symptoms,and prognosis.Results In the observation group,24 cases were significantly effective and 20 cases were effective.The total effective rate of the observation was 97.78%(44/45),which was higher than 86.67%(39/45)of the control group(P<0.05).Before treatment,there was no significant difference in the levels of CRP,PCT and WBC in peripheral blood between the two groups(P>0.05).After treatment,the levels of CRP,PCT and WBC in peripheral blood in both groups were lower than those before treatment,and the observation group was significantly lower than the control group(P<0.05).PaO_(2) and SaO_(2) in both groups after treatment were higher than those before treatment(P<0.05).There was no significant difference between the two groups before and after treatment(P>0.05).The antipyretic time,cough disappearance time,lung moist rales disappearance time and chest pain disappearance time were(1.23±0.21),(1.63±0.51),(2.36±0.51)and(2.98±0.12)d in the observation group,which significantly shorter than(2.31±0.36),(3.21±0.61),(3.59±0.41)and(3.98±0.26)d in the control group(P<0.05).The incidence of adverse reactions suc

关 键 词：盐酸氨溴索 纤维支气管镜灌洗 老年重症肺炎 炎症状态 血气指标 大剂量 

分 类 号：R563.1[医药卫生—呼吸系统]