CAJ | 학술논문

目的评价大剂量氨溴索在气道高反应患者术中应用效果.方法将择期下腹部及下肢手术患者60例采用随机数字表法分为对照组及氨溴索组,各30例.插入气管导管后氨溴索组静脉输注氨溴索5 mg/kg,1h输注完毕；对照组输注相同容积的生理盐水,1h输注完毕,监测指标包括麻醉前(T0)、麻醉后10 min(T1)、0.5 h(T2)、2 h(T3)血气情况、氧合指数、气道峰压值及术后气道痉挛、苏醒时间、抗生素使用时间及肺部感染情况.结果氨溴索组术中肺功能改善情况明显,T2、T3 PaO2值分别为(319 ±6)和(326 ±8)mm Hg(1 mm Hg =0.133 kPa),较用药前[(177±3)mm Hg]升高.对照组无明显变化,用药后氨溴索组T3 PaO2明显高于对照组[(267 ±6)mm Hg] (P ＜0.05)；用药后氨溴索组T3气道压[(15.5±1.1)cm H2O(1 cm H2O=0.098 kPa)]低于用药前[(26.6±3.4) cm H2O]及对照组用药后[(24.2±2.8)cm H2O](P＜0.05).氨溴索组苏醒时间为(13±4) min,对照组为(27±5)min；术后气道痉挛氨溴索组3例、对照组10例；术后肺部感染氨溴索组3例、对照组11例.氨溴索组术后苏醒时间、气道痉挛及肺部感染比例均低于对照组,差异均有统计学意义(均P＜0.05).结论大剂量氨溴索在气道高反应患者围术期应用效果良好,可明显改善患者预后.
목적 평개대제량안추색재기도고반응환자술중응용효과.방법 장택기하복부급하지수술환자60례채용수궤수자표법분위대조조급안추색조,각30례.삽입기관도관후안추색조정맥수주안추색5 mg/kg,1h수주완필；대조조수주상동용적적생리염수,1h수주완필,감측지표포괄마취전(T0)、마취후10 min(T1)、0.5 h(T2)、2 h(T3)혈기정황、양합지수、기도봉압치급술후기도경련、소성시간、항생소사용시간급폐부감염정황.결과 안추색조술중폐공능개선정황명현,T2、T3 PaO2치분별위(319 ±6)화(326 ±8)mm Hg(1 mm Hg =0.133 kPa),교용약전[(177±3)mm Hg]승고.대조조무명현변화,용약후안추색조T3 PaO2명현고우대조조[(267 ±6)mm Hg] (P ＜0.05)；용약후안추색조T3기도압[(15.5±1.1)cm H2O(1 cm H2O=0.098 kPa)]저우용약전[(26.6±3.4) cm H2O]급대조조용약후[(24.2±2.8)cm H2O](P＜0.05).안추색조소성시간위(13±4) min,대조조위(27±5)min；술후기도경련안추색조3례、대조조10례；술후폐부감염안추색조3례、대조조11례.안추색조술후소성시간、기도경련급폐부감염비례균저우대조조,차이균유통계학의의(균P＜0.05).결론 대제량안추색재기도고반응환자위술기응용효과량호,가명현개선환자예후.
Objective To investigate the effect of perioperative using large dose of ambroxol in patients with poor lung function.Methods Sixty patients were randomly divided into two groups:control group (group B) and ambroxol group (group A).After intubation,group A was injected with ambroxol 5 mg/kg in 1 hour,while group B was injected same volume normal saline in 1 hour.Vital signs including blood gas,oxygenation index,airway pressure peak,awake time,the cases of bronchospasm after surgery,the time of using antibiotics and the cases with pulmonary infection after surgery were analyzed.Results The perioperative improvement of lung function in group A was significant while there was no significant change in group B.PaO2 value after using ambroxol increased to (319 ±6)mm Hg and (326 ±8)mm Hg and the value before using ambroxol was (177 ±3)mm Hg in group A,the value was (267 ± 6) mm Hg in group B.Airway pressure value decreased to (15.5 ± 1.1) cm H2O after using ambroxol in group A,lower than the value of before using ambroxol [(26.6 ±3.4) cm H2O] and the value of group B [(24.2 ± 2.8) cm H2 O].The last of awake time in group A [(13 ± 4) min] was more shorter than that in group B [(27 ± 5)min].The cases of bronchospasm and lung infection in group A (3 cases/3 cases)were lower than those in group B(10 cases/11 cases) (P ＜0.05).Conclusion The effect of perioperative using large dose of ambroxol in patients with high airway react is effective and can improve the prognosis.