CAJ | 학술논문

目的：观察氨溴索对急性呼吸窘迫综合征（ARDS）患者肺保护的效果。方法对我院 ICU 收治的64例静脉输注盐酸氨溴索和30例未用盐酸氨溴索 ARDS 患者的呼吸功能变化情况进行回顾性对比分析。结果未用盐酸氨溴索（空白对照组，Ⅰ组）、常规剂量组（Ⅱ组）、大剂量组（Ⅲ组）3组患者入 ICU 时的年龄、体质量、APACHEⅡ评分、痰液量、氧合指数（OI）均无显著差异。经不同治疗后，第1个24 h 痰液量分别为（23.67±18.05）、（46.70±38.15）、（158.26±75.20）ml，第2个24 h Ⅲ组痰液量减少为（110.05±51.00）ml；治疗3 d 后，Ⅰ、Ⅱ、Ⅲ组 OI 分别为（69.46±32.00）、（67.05±41.50）、（108.35±38.02）mmHg，肺顺应性分别为（5.19±2.44）、（7.02±2.00）、（26.45±12.42）ml/ mba，机械通气时间分别为（89.74±22.22）、（80.46±12.78）、（69.89±23.59）h，3组间均有统计学差异（P ﹤0.05）。结论常规剂量和大剂量盐酸氨溴索对祛痰均有效，但大剂量对机械通气患者肺保护作用可能更佳。
목적：관찰안추색대급성호흡군박종합정（ARDS）환자폐보호적효과。방법대아원 ICU 수치적64례정맥수주염산안추색화30례미용염산안추색 ARDS 환자적호흡공능변화정황진행회고성대비분석。결과미용염산안추색（공백대조조，Ⅰ조）、상규제량조（Ⅱ조）、대제량조（Ⅲ조）3조환자입 ICU 시적년령、체질량、APACHEⅡ평분、담액량、양합지수（OI）균무현저차이。경불동치료후，제1개24 h 담액량분별위（23.67±18.05）、（46.70±38.15）、（158.26±75.20）ml，제2개24 h Ⅲ조담액량감소위（110.05±51.00）ml；치료3 d 후，Ⅰ、Ⅱ、Ⅲ조 OI 분별위（69.46±32.00）、（67.05±41.50）、（108.35±38.02）mmHg，폐순응성분별위（5.19±2.44）、（7.02±2.00）、（26.45±12.42）ml/ mba，궤계통기시간분별위（89.74±22.22）、（80.46±12.78）、（69.89±23.59）h，3조간균유통계학차이（P ﹤0.05）。결론상규제량화대제량염산안추색대거담균유효，단대제량대궤계통기환자폐보호작용가능경가。
Objective To observe the protective effect of ambroxol on lungs of the patients with acute respiratory distress syndrome(ARDS). Methods The changes of respiratory function were compared between 64 cases with ARDS receiving intravenous infusion of amboxol and 30 cases with ARDS receiving no intravenous infusion of ambroxol hospitalized in ICU and a retrospective analysis was made. Results There existed no obvious difference in age,body mass,APACHE Ⅱ scores,amount of sputum and oxygenation index(OI)among the cases in the 3 groups(control group as group Ⅰ,amboxol routine dose group as group Ⅱ and large dose group as group Ⅲ);at the 24th hour after treatment,the amounts of sputum of the cases in the 3 groups were(23. 67 ± 18. 05)ml, (46. 70 ± 38. 15)ml and(158. 26 ± 75. 20)ml,respectively,and at the 48th hour after treatment,the amount of sputum in group Ⅲdropped down to(110. 05 ± 51. 00)ml;3 days after treatment,the OI of the cases in the 3 groups were(69. 46 ± 32. 00)mmHg, (67. 05 ± 41. 50)mmHg and(108. 35 ± 38. 02)mmHg,respectively;the lung compliance were(5. 19 ± 2. 44)ml/ mba,(7. 02 ± 2. 00) ml/ mba and(26. 45 ± 12. 42)ml/ mba,respectively;mechanical ventilation time was(89. 74 ± 22. 22)hours,(80. 46 ± 12. 78)hours and(69. 89 ± 23. 59)hours,respectively;the difference among the 3 groups was of statistical significance(P ﹤ 0. 05). Conclusions Routine dose ambroxol and large dose ambroxol are of good expectorant effect,while large dose amboxol is of better protective effect on lungs of the cases with mechanical ventilation.