CAJ | 학술논문

目的：探讨围术期应用氨溴索和呼吸训练器对体外循环术后患者排痰效果的影响。方法将2010年11月至2011年8月山东大学齐鲁医院心脏外科行心脏瓣膜置换手术的80例患者按随机对照实验方法分为氨溴索与呼吸训练器联合组（A 组）、氨溴索组（B 组）、呼吸训练器组（C 组）和对照组（D 组），比较各组患者的术后咳嗽程度、痰液黏稠度、排痰难度、呼吸机辅助通气时间及 ICU 监护时间。结果各组患者术后咳嗽程度无明显差异；氨溴索组和联合组痰液黏稠度较其他组低（P ＜0．05），两组间无明显差异；氨溴索组和联合组排痰难度较其他组低（P ＜0．01），而联合组排痰难度较氨溴索组更低（P ＜0．05）。联合组呼吸机辅助时间及 ICU 入住时间均明显短于其他3个组别，差异均有统计学意义（P ＜0．05）。结论围术期联合应用呼吸训练器和氨溴索可以发挥协同作用，更有效地促进体外循环术后患者排痰。
목적：탐토위술기응용안추색화호흡훈련기대체외순배술후환자배담효과적영향。방법장2010년11월지2011년8월산동대학제로의원심장외과행심장판막치환수술적80례환자안수궤대조실험방법분위안추색여호흡훈련기연합조（A 조）、안추색조（B 조）、호흡훈련기조（C 조）화대조조（D 조），비교각조환자적술후해수정도、담액점주도、배담난도、호흡궤보조통기시간급 ICU 감호시간。결과각조환자술후해수정도무명현차이；안추색조화연합조담액점주도교기타조저（P ＜0．05），량조간무명현차이；안추색조화연합조배담난도교기타조저（P ＜0．01），이연합조배담난도교안추색조경저（P ＜0．05）。연합조호흡궤보조시간급 ICU 입주시간균명현단우기타3개조별，차이균유통계학의의（P ＜0．05）。결론위술기연합응용호흡훈련기화안추색가이발휘협동작용，경유효지촉진체외순배술후환자배담。
Objective To investigate the effect of expectoration after extracorporeal circulatin operation by the application of ambroxol and respiration training device during perioperative time.Methods Eighty patients who had been performed cardiac valve replacement were divided into group of Ambroxol combined with respiration training device (group A),group of Ambroxol (group B),group of respiration training device (group C)and control group (group D).The cough,viscidity of sputum,difficult of expectoration,the time of breathing machine assisted ventilation and the time in ICU were compared between groups.Results There was no significant difference of cough level between groups,and the group A and group B had lower level of viscidity of sputum compared with other groups (P < 0.05 ),also the group A and group B had less difficulty to expectoration compared with other groups (P < 0.01 ),while the group A even had less difficulty than group B (P <0.05).The time of breathing machine assisted ventilation and time to stay in ICU in group A were shorter than other three groups (P <0.05).Conclusion The application of ambroxol and respiration training device during perioperative time could contribute to promote expectoration effectively.