盐酸氨溴索联合纤维支气管镜肺泡灌洗在老年重症肺炎患者中的应用效果

朱建凤; 王红娟

doi:10.7619/jcmp.202001021

盐酸氨溴索联合纤维支气管镜肺泡灌洗在老年重症肺炎患者中的应用效果

朱建凤¹,
王红娟^2, ,

1. 陕西省西安市第八医院内科, 陕西西安, 710061;
2. 陕西省西安凤城医院呼吸与危重症医学科, 陕西西安, 710016

详细信息

通讯作者:
王红娟, E-mail: 1466935670@qq.com

中图分类号: R563.1
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出版历程
- 收稿日期: 2019-10-24
- 网络出版日期: 2020-12-22
- 发布日期: 2020-08-06

Effect of ambroxol hydrochloride combined with fiberoptic bronchoscopy alveolar lavage in senile patients with severe pneumonia

ZHU Jianfeng¹,
WANG Hongjuan^2, ,

1. Department of Internal Medicine, The Eighth Hospital of Xi'an City in Shaanxi Province, Xi'an, Shaanxi, 710061;
2. Department of Respiratory and Critical Care Medicine, Xi'an Fengcheng Hospital in Shaanxi Province, Xi'an, Shaanxi, 710016

摘要

摘要: 目的探讨盐酸氨溴索联合纤维支气管镜肺泡灌洗对老年重症肺炎患者的效果及对氧合指数、Murray肺损伤评分(MLIS)、金属基质蛋白酶-9(MMP-9)的影响。方法选取老年重症肺炎患者96例,按随机数字表法分为对照组与观察组。对照组46例采用盐酸氨溴索治疗,观察组50例采用盐酸氨溴索联合纤维支气管镜肺泡灌洗治疗,对比2组患者的临床疗效、氧合指数及MLIS、MMP-9情况。结果治疗后1周,观察组总有效率高于对照组,差异有统计学意义(P<0.05); 观察组退热、咳嗽、咳痰、肺部湿啰音以及胸痛消失时间短于对照组,差异有统计学意义(P<0.05); 观察组动脉血氧分压［p(O₂)］、动脉氧饱和度(SaO₂)、氧合指数显著高于对照组,动脉血二氧化碳分压［p(CO₂)］低于对照组,差异有统计学意义(P<0.05); 观察组MLIS、临床肺部感染评分(CPIS)及急性生理与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分低于对照组,差异有统计学意义(P<0.05); 观察组Toll样受体4(TLR4)、Ⅳ型胶原蛋白(Ⅳ-C)、MMP-9、C反应蛋白(CRP)、白细胞计数(WBC)、降钙素原(PCT)水平低于对照组,差异有统计学意义(P<0.05); 治疗后1周, 2组肺功能指标水平均高于治疗前,且观察组用力肺活量(FVC)、第1秒用力呼气容积(FEV₁)、FEV₁/FVC、最大呼气中段流量(MMF)及呼气峰值流速(PEF)指标水平均高于对照组,差异有统计学意义(P<0.05); 观察组不良反应总发生率低于对照组,但2组差异无统计学意义(P>0.05)。结论盐酸氨溴索联合纤维支气管镜肺泡灌洗应用于老年重症肺炎患者有很好的临床疗效,能有效改善动脉血气指标,减轻炎症反应,改善肺功能,提高患者生存质量。
- 盐酸氨溴索 /
- 纤维支气管镜肺泡灌洗 /
- 老年重症肺炎 /
- 疗效 /
- 氧合指数 /
- Murray肺损伤评分
Abstract: Objective To investigate the effect of ambroxol hydrochloride combined with fiberoptic bronchoscopy alveolar lavage in the elderly with severe pneumonia, and its impact on the oxygenation index, Murray lung injury score(MLIS)and metal matrix protease-9(MMP-9). Methods A total of 96 elderly patients with severe pneumonia were divided into control group and observation group according to random table method. The control group(n=46)was treated with ambroxol hydrochloride, while the observation group(n=50)was given ambroxol hydrochloride combined with fiberoptic bronchoscopy alveolar lavage. Clinical efficacy, oxygenation index and MLIS, MMP-9 of two groups were compared. Results At 1 week after treatment, the total effective rate of the observation group was significantly higher than that of the control group(P<0.05). The disappearance time of fever, cough, expectoration, lung rales and chest pain in the observation group was significantly shorter than that in the control group(P<0.05). The arterial oxygen partial pressure［p(O₂)］, - arterial oxygen saturation(SaO₂)and oxygenation index of the observation group were significantly higher than those of the control group, while the arterial carbon dioxide partial pressure ［p(CO₂)］ was lower than that of the control group(P<0.05). The scores of MLIS, CPIS and physiology and chronic health score(APACHE Ⅱ)in the observation group were lower than those in the control group(P<0.05); the levels of Toll like receptor 4(TLR4), type Ⅳ collagen(Ⅳ-C), MMP-9, C reactive protein(CRP), leukocyte count(WBC)and procalcitonin(PCT)in the observation group were lower than those in the control group, the differences were statistically significant(P<0.05). At 1 week after treatment, the lung function indexes of the two groups were higher than those before treatment, and the indexes of forced vital capacity(FVC), forced expiratory volume per second(FEV₁), FEV₁/FVC, maximum midexpiratory flow(MMF)and peak expiratory flow(PEF)of the observation group were higher than those of the control group, the differences were statistically significant(P<0.05). The incidence of adverse reactions in the observation group was lower than that in the control group, but no significant difference was found(P>0.05). Conclusion Ambroxol hydrochloride combined with fiber bronchoscopy alveolar lavage has a good clinical effect for the elderly with severe pneumonia, which can effectively improve the arterial blood gas index, reduce inflammatory reactions, improve lung function and quality of life.
- ambroxol hydrochloride /
- alveolar lavage with fiberoptic bronchoscopy /
- severe pneumonia in the elderly /
- curative effect /
- oxygen index /
- Murray lung injury score

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