CAJ | 학술논문

目的：比较不同剂量盐酸氨溴索预防经口咽入路寰枢椎手术肺部并发症的效果及安全性。方法行经口咽入路寰枢椎手术患者120例，按随机数字法分为A、B、C 3组（每组40例），A组给予小剂量盐酸氨溴索30 mg，3次／d，静脉滴注；B组给予中等剂量盐酸氨溴索90 mg，3次／d，静脉滴注；C组给予大剂量盐酸氨溴索300 mg，3次／d，静脉滴注。观察各组患者气管导管留置时间、肺部并发症发生率、抗生素使用时间及不良反应情况。结果在气管导管留置时间、不良反应发生率方面，A、B、C 3组比较差异无统计学意义（ P＞0.05）；与A组比较， B、C两组在肺部并发症发生率、抗生素使用时间方面差异有统计学意义（ P＜0.05）。 B、C两组在肺部并发症发生率、抗生素使用时间方面差异无统计学意义（ P＞0.05）。结论在预防经口咽入路寰枢椎手术肺部并发症方面，中等剂量及大剂量氨溴索较小剂量有更好的疗效及较好的安全性。与中等剂量相比，大剂量盐酸氨溴索未显示更高的性价比，不推荐常规使用大剂量盐酸氨溴索预防经口咽入路寰枢椎手术肺部并发症。
목적：비교불동제량염산안추색예방경구인입로환추추수술폐부병발증적효과급안전성。방법행경구인입로환추추수술환자120례，안수궤수자법분위A、B、C 3조（매조40례），A조급여소제량염산안추색30 mg，3차／d，정맥적주；B조급여중등제량염산안추색90 mg，3차／d，정맥적주；C조급여대제량염산안추색300 mg，3차／d，정맥적주。관찰각조환자기관도관류치시간、폐부병발증발생솔、항생소사용시간급불량반응정황。결과재기관도관류치시간、불량반응발생솔방면，A、B、C 3조비교차이무통계학의의（ P＞0.05）；여A조비교， B、C량조재폐부병발증발생솔、항생소사용시간방면차이유통계학의의（ P＜0.05）。 B、C량조재폐부병발증발생솔、항생소사용시간방면차이무통계학의의（ P＞0.05）。결론재예방경구인입로환추추수술폐부병발증방면，중등제량급대제량안추색교소제량유경호적료효급교호적안전성。여중등제량상비，대제량염산안추색미현시경고적성개비，불추천상규사용대제량염산안추색예방경구인입로환추추수술폐부병발증。
Objective To compare the efficacy and safety of different doses of ambroxol hydrochloride in the pre-vention of pulmonary complications following transoral atlantoaxial surgery.Methods 120 patients who underwent tran-soral atlantoaxial surgery were randomly divided into three groups (40 cases per group) .Patients in Group A were given low dose of ambroxol hydrochloride, 30 mg intravenous infusion, three times a day.Patients in Group B were given a me-dium dosage of ambroxol hydrochloride, 90 mg intravenous infusion, three times a day.Patients in Group C were given a large dose of ambroxol hydrochloride, 300 mg, intravenous infusion, three times a day.Endotracheal tube detaining time, incidence rate of pulmonary complications, duration of antibiotics application and rate of adverse reaction were compared a-mong the groups.Results There was no significant difference in endotracheal tube detaining time and rate of adverse re-action among the groups ( P>0.05) .Incidence rates of pulmonary complications and durations of antibiotics application in Groups B and C were significantly lower than those in Group A ( P<0.05 ) , but not significantly different between Groups B and C (P>0.05).Conclusion Medium and high dose of ambroxol hydrochloride are safer and more effective in the prevention of pulmonary complications following transoral atlantoaxial surgery.High dose of ambroxol hydrochloride does not demonstrate better outcomes and therefore is not recommended for prevention of pulmonary complications following transoral atlantoaxial surgery.