摘要
目的:探讨胸腔镜右肺下叶切除术后应用大剂量氨溴索的短期预后效果。方法:选取某院全麻双腔插管胸腔镜下右肺下叶切除术的患者100例为研究对象,随机分为大剂量组和常规剂量组,各50例。大剂量组术后予以500 mg/d氨溴索注射液静脉滴入,常规剂量组术后予以60 mg/d氨溴索注射液静脉滴入,2组疗程均为5 d,比较2组患者术后肺功能指标[第一秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、第一秒用力呼气容积和用力肺活量的比值(FEV_(1)/FVC)]、炎症因子水平(CRP、TNF-α)、术后抗生素应用时间、咳痰难易程度、术后并发症及氨溴索相关不良反应发生率。结果:治疗结束后,2组患者肺功能指标均低于术前,大剂量组FEV_(1)、FVC、FEV_(1)/FVC[(2.14±0.37)L、(2.34±0.32)L、(84.32±4.31)%]均高于常规剂量组[(1.78±0.46)L、(2.13±0.39)L、(78.46±3.47)%](P<0.05);术后2组患者炎症相关指标均高于术前,术后第5天大剂量组CRP及TNF-α计数[(5.24±1.37)mg/L、(5.78±2.96)ng/L]均低于常规剂量组[(6.45±2.13)mg/L、(7.38±3.25)ng/L](P<0.05);术后2组患者咳痰难易程度评分均高于术前,大剂量组咳痰难易程度评分[(2.33±0.72)分]高于常规剂量组[(2.06±0.36)分](P<0.05);大剂量组抗生素使用时间[(4.53±1.23)d]短于常规剂量组[(5.32±1.34)d](P<0.05)。大剂量组术后短期并发症发生率(12%)小于常规剂量组(30%)(P<0.05);大剂量组术后氨溴索相关不良反应发生率(10%)与常规剂量组(8%)比较差异无统计学意义。结论:胸腔镜肺叶切除术后应用大剂量氨溴索较常规剂量更有利于患者肺功能恢复、减轻炎症反应、加快呼吸道分泌物排出,缩短抗生素应用时间及减少术后并发症发生,且大剂量组不增加氨溴索相关不良反应的发生。
Objective:To explore the short-term prognostic effect of large dose ambroxol after thoracoscopic lobectomy.Methods:100 patients in a hospital undergoing thoracoscopic resection of right lower lobe with double lumen intubation under general anesthesia were selected and randomly divided into a large dose group and a routine dose group, with 50 cases in each.The large dose group was treated with intravenous infusion of ambroxol 500 mg/d, while the routine dose group was given intravenous infusion of ambroxol 60 mg/d. The course of treatment for both groups was 5 days.After the operation, the patients in the two groups were compared in terms of FEV_(1), FVC, FEV_(1)/FVC,CRP,TNF-α,time of postoperative use of antibiotics, difficulty degree of expectoration, postoperative complications, and incidence of adverse reactions related to ambroxol.Results:After the treatment, the indexes of lung function for both groups were lower than those before the treatment.FEV_(1),FVC,and FEV_(1)/FVC[(2.14±0.37)L,(2.34±0.32)L,(84.32±4.31)%]of the large dose group were all higher than those of the routine group[(1.78±0.46)L,(2.13±0.39)L,(78.46±3.47)%].After the operation, the inflammatory markers for both groups were higher than those before the treatment.5 d after the operation, CRP and TNF-αcount[(5.24±1.37)mg/L,(5.78±2.96)ng/L]of the large dose group were lower than those of the routine group[(6.45±2.13)mg/L,(7.38±3.25)ng/L](P<0.05).After the operation, scores of difficulty degree of expectoration of the two groups were higher than those before the operation.The score for the large dose group was(2.33±0.72),higher than that of the routine group(2.06±0.36).The time of postoperative use of antibiotics for the large dose group was(4.53±1.23)d, shorter than that for the routine group(5.32±1.34)d.The postoperative short-term incidence of complications for the large dose group(12%) was lower than that of the routine group(30%)(P<0.05).The difference between the postoperative incidence of adverse reactions related to ambroxol for the large dose group(10%) and for the routine group(8%) was of no statistical significance.Conclusion:Use of large dose of ambroxol after the thoracoscopic lobectomy, compared with routine dose, can be conducive to the recovery of patients’ pulmonary function, alleviate the inflammatory reaction, accelerate the excretion of respiratory secretions, shorten the time of use of antibiotics, and reduce the postoperative complications. What’s more, use of large dose of ambroxol does not increase the relevant adverse reactions.
作者
孙祥祥
杨云龙
SUN Xiangxiang;YANG Yunlong(Beihua University,Jilin,Jilin 132000,China)
出处
《淮海医药》
CAS
2022年第6期581-585,共5页
Journal of Huaihai Medicine
基金
吉林省科技发展计划项目(20200403116SF)。
