CAJ | 학술논문

目的：探讨肺癌手术中气道内滴入大剂量氨溴索溶液方法对肺癌术后患者恢复的影响作用。方法：江苏省徐州市第一人民医院胸外科2009年1月~2011年1月收治的肺癌患者90例，随机分成两组，对照组(A组)患者围术期静脉滴注氨溴索，实验组(B组)患者围术期静滴氨溴索溶液同时，术中2h经气管插管予气道内滴入大剂量氨溴索，术后观察咳痰情况、术后肺部并发症的发生率、胸腔闭式引流时间、平均住院时间及术后抗生素的使用时间。结果：术后5天B组的痰液性质和咳痰难易程度明显优于A组，且具有统计学差异(P<0.05)；B组肺部感染、肺不张、急性呼吸窘迫综合征的发生率、胸腔闭式引流管时间、患者平均住院时间、抗生素的使用时间等均明显低于A组(P<0.05)。结论：围手术期合理使用氨溴索祛痰，尤其是全身麻醉过程中经气管插管予大剂量的氨溴索溶液能有效改善手术患者肺功能，促进痰液稀释、缩短抗生素使用时间，对防止肺部并发症等有明显作用，在一定程度上减低患者医疗经济成本。
목적：탐토폐암수술중기도내적입대제량안추색용액방법대폐암술후환자회복적영향작용。방법：강소성서주시제일인민의원흉외과2009년1월~2011년1월수치적폐암환자90례，수궤분성량조，대조조(A조)환자위술기정맥적주안추색，실험조(B조)환자위술기정적안추색용액동시，술중2h경기관삽관여기도내적입대제량안추색，술후관찰해담정황、술후폐부병발증적발생솔、흉강폐식인류시간、평균주원시간급술후항생소적사용시간。결과：술후5천B조적담액성질화해담난역정도명현우우A조，차구유통계학차이(P<0.05)；B조폐부감염、폐불장、급성호흡군박종합정적발생솔、흉강폐식인류관시간、환자평균주원시간、항생소적사용시간등균명현저우A조(P<0.05)。결론：위수술기합리사용안추색거담，우기시전신마취과정중경기관삽관여대제량적안추색용액능유효개선수술환자폐공능，촉진담액희석、축단항생소사용시간，대방지폐부병발증등유명현작용，재일정정도상감저환자의료경제성본。
Objective:To explore the clinical effect of intraoperative treatment with airway instillation large doses ambroxol solution for the recovery of the patients with lung cancer after received surgery.Methods:Collected 90 cases lung cancer patients which received surgery in the first people's hospital of Xuzhou city during January 2009 to January 2011,all patients were divided into two group randomly,the control group(group A) received perioperative infusion treatment with single ambroxol,the test group received the combined intraoperative treatment with infusion and airway instillation large doses ambroxol solution,then observed the expectoration behavior,pulmonary complications,the time of closed thoracic drainage,the average hospitalization time and the time of antibiotics treatment.Results:Five days after surgery,the sputum nature and the degree of difficulty for sputum of B group was better than A group,and has statistically significant difference (P>0.05);the incidence of lung infection,atelectasis and acute respiratory distress syndrome,the time of closed thoracic drainage,the average hospitalization time and the time of antibiotics treatment of group B was significantly better than group A (P<0.05).Conclusion:Use ambroxol to expectorant for the lung cancer patients and especially undertake an endotracheal intubation treatment with large dose ambroxol solution during the process of anesthesia,could improve the lung function of patients,promote mucus dilution,and reduce the time of antibiotics treatment and prevent the lung ministry of complications,to some extent,also could reduce the economic costs of patient care.