摘要
目的:探讨布地奈德联合氨溴索氧化驱动雾化吸入对于预防成人开胸术后肺炎的临床效果。方法:采用随机、开放、平行的病例对照试验,于西安交通大学第一附属医院胸外二科住院患者中选择符合研究标准的患者80例作为研究对象。入组患者随机分为实验组和对照组,实验组患者进行术前3 d的雾化吸入用药,采用氧化驱动布地奈德2 mg联合氨溴索60 mg雾化吸入,对照组术前不进行雾化吸入,各组患者术后治疗方案一致。结果:基线资料显示,两组间患者在性别、年龄、病种、吸烟情况等方面差异不具有统计学意义(P>0.05)。手术前12 h血气分析结果显示,实验组PaO_2为(88.40±9.40)mm Hg,PaCO_2为(38.30±6.10)mm Hg;对照组PaO_2为(85.09±7.18)mm Hg,PaCO_2为(41.21±3.15)mm Hg,两组P值分别为0.029和0.011,差异具有统计学意义。实验组40例患者中发生术后肺炎者3例,发生率为7.50%;对照组40例患者中发生术后肺炎患者10例,发生率为25.00%,P值为0.034,差异具有统计学意义。进一步分析不同病种及手术方式对术后肺炎发生率的影响,显示在实验组及对照组中,食管癌患者的术后肺炎发生率均较肺癌患者术后肺炎发生率低,差异具有统计学意义(P<0.05)。实验组中肺楔形切除术、肺叶肺段切除术及肺袖式切除术例数分别为2、21及1例,对照组中相应例数为2、21及2例。两组间,肺癌不同手术方式患者的术后肺炎发生率差异具有统计学意义(P<0.05)。结论:患者术前3 d应用布地奈德联合氨溴索氧化驱动雾化吸入进行呼吸道准备,可大大减低术后肺炎的发生率。
Objective： To study the clinical effect of the oxygen drive aerosol in halation with budesonide and ambroxol in the prevention of adult post-thoracotomy pneumonia. Methods： This was a randomized,open and parallel controlled trial. We chose 80 cases of patients in the department of thoracic surgery in the First Affiliated Hospital of Xi＇an Jiaotong University which fitted our criteria as the research object. The selected patients were randomly divided into the active group and the control group,and the active group underwent oxygen drive aerosol inhalation （2 mg budesonide combined 60 mg ambroxol） for 3 days before operation,and the control group without preoperative aerosol inhalation,and their postoperative therapy was the same. Results： The baseline data showed that the differences in sex,age,disease and smoking were not statistically significant between the two groups,P 0. 05. The results of blood gas analysis before 12 hours of operation suggested that,the PaO_2 and PaCO_2 values of the active group were （88. 40 ± 9. 40） mm Hg and （38. 30 ± 6. 10） mm Hg; The PaO_2 and PaCO_2 values of the control group were （85. 09 ± 7. 18） mm Hg and （41. 21 ± 3. 15） mm Hg. And the two groups＇ P values were0. 029 and 0. 011,with statistical differences. There were 3 patients who developed postoperative pneumonia out of 40 patients in the active group,the incidence was 7. 50%,but the incidence of control group was 25. 00%. The P value was 0. 034,with statistical differences. We also analyzed the influence of different diseases and surgical methods on postoperative pneumonia,and the results showed that in the active group and the control group,the incidence of postoperative pneumonia in the patients with esophageal cancer was lower than that in lung cancer patients,and there was a statistically significant difference （P 〈0. 05）. In the active group,the numbers of pulmonary deed resection,lobectomy and pulmonary sleeve resection were 2,21 and 1 cases respectively,and the corresponding numbers in the control group were 2,21 and 2. Among the two groups,the incidence of postoperative pneumonia in the patients with different surgical methods of lung cancer was statistically significant （P 0. 05）. Conclusion： If we implement respiratory preparation with budesonide plus ambroxol inhalation for 3 days before operation,we can greatly reduce the incidence of postoperative pneumonia.
作者
李刚
王健生
秦思达
张佳
杜宁
张靖
孙欣
任宏
LI Gang;WANG Jian-sheng;QIN Si-da;ZHANG Jia;DU Ning;ZHANG Jing;SUN Xin;REN Hong(Second Department of Thoracic Surgery,First Affiliated Hospital of Xi＇an Jiaotong University,Xi＇an 710061,China)
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2018年第5期840-844,共5页
Journal of Peking University:Health Sciences
