不同雾化吸入方案对肺切除病人术后痰液黏弹性的影响  

The effect of different inhalation formula on sputum viscoelasticity of patients after pneumonectomy

作　　者：王建荣[1] 张黎明[1] 韩忠福[1] 秦力君[1] 马燕兰[1] 杨成秀[1] 

机构地区：[1]北京市解放军总医院护理部,100853

出　　处：《中华护理杂志》2003年第7期500-503,共4页Chinese Journal of Nursing

基　　金：全军"九五"科研基金资助项目(98M14 3)

摘　　要：目的 :探讨适用于肺切除术后病人的更理想的雾化吸入方案 ,以促进病人有效排痰 ,预防术后肺部并发症。方法 :采用正交设计实验方案 ,4个研究因素即雾化吸入的湿化剂、祛痰剂、解痉药和抗生素 ,每因素为 3个水平 ,选用L2 7(34 )正交设计表 ,按确定的实验方案随机分配给入选病人。观察病人吸入不同雾化液时术后 1～ 5d痰液黏弹性的变化。结果 :肺切除术后病人雾化吸入生理盐水时 ,第 1天痰液黏弹性明显降低 ;吸入碳酸氢钠者术后 2～ 5d痰液黏弹性维持在较低水平 ;雾化吸入祛痰剂糜蛋白酶或必嗽平时比不加药者术后第 1天痰黏弹性显著降低 ;雾化液中加入抗生素和气道解痉药时 ,病人痰黏弹性在一定程度上降低。结论 :肺切除术后病人雾化吸入应首选生理盐水加糜蛋白酶及庆大霉素、地塞米松 。Objective:To explore more ideal inhalation formula for patients after pneumonectomy in order to improve expectoration. Methods:Following orthogonal design, 4 research factors including wetting agent, expectorants, anticonvulsive drug and antibiotics, and 3 levels of each factors were taken in the experiment. L 27 (3 4)designed table was applied. Patients were randomly arranged to different inhalation formula. Sputum viscoelasticity on 1 to 5 P.O.D. after inhalation of different formula aerol were observed. Results:Sputum viscosity and elasticity on 1 P.O.D were lower after inhalation of saline, however, those indicators on 2-5 P.O.D. were lower after inhalation of sodium bicarbonate. They are also lower in patients who inhalated expectorants, alpha-chymar or bromhexine, than those without expectorants. Sputum viscoelasticity is lower when patients inhalated anticonvulsive drug or antibacterial agent. Conlusion: It is the better choice for patients after pneumonectomy to inhale saline with chymar, gentamicin,dexamethasone. This formula inhalalion has a better effect in decreasing of sputum viscoelasticity.

关 键 词：肺切除术 祛痰药 雾化吸入治疗 生理盐水 糜蛋白酶 庆大霉素 地塞米松 

分 类 号：R473.6[医药卫生—护理学]