摘要
目的 探讨雾化三联药物对肺癌肺叶切除术后患者的疗效等的影响。方法 选取自2020年1月至2023年11月南通市第六人民医院196例行胸腔镜肺叶切除术治疗的肺癌患者,根据术后雾化药物治疗的差异分为2组。其中研究组患者100例,采用雾化吸入布地奈德、特布他林及吸入用乙酰半胱氨酸三联药物治疗,而对照组患者96例,则术中采用布地奈德联合特布他林雾化吸入治疗,比较2组临床疗效等差异。结果 治疗后研究组咳嗽缓解的具体时间、湿啰音减少的具体时间及术后住院的具体时间[分别是(5.5±1.1) d、(6.5±1.2) d、(8.0±1.5) d],短于对照组[分别是(8.7±1.5) d、(7.6±1.4) d、(10.8±2.5) d],差异有统计学意义(t=17.080、5.914、9.552,均P<0.05)。治疗后研究组并发症发生率2.0%(2/100),和对照组2.1%(2/96)相比,差异无统计学意义(χ^(2)=0.002,P=0.967)。治疗后,研究组和对照组患者PEF、MVV、FEV1/FVC[分别是(85.0±11.1)L,(78.3±9.9)L;(3.8±1.1)L·s^(-1),(2.7±0.7)L·s^(-1);(82.9±10.5)%,(75.7±8.8)%],高于治疗前[分别是(62.4±8.0)L,(62.1±8.5)L;(2.0±0.6)L·s^(-1),(2.1±0.5)L·s^(-1);(60.7±8.9)%,(60.3±7.7)%],且研究组高于对照组,差异有统计学意义(t=4.327、5.011、4.490,均P<0.05)。治疗后,研究组和对照组患者C反应蛋白(CRP)、降钙素原(PCT)[分别是(9.5±1.7)mg·L^(-1),(13.7±1.5)mg·L^(-1);(3.3±0.6)μg·L^(-1),(4.2±1.1)μg·L^(-1)],低于治疗前[分别是(18.3±2.5)mg·L^(-1),(18.5±2.7)mg·L^(-1);(5.4±1.0)μg·L^(-1),(5.3±1.2)μg·L^(-1)]且研究组低于对照组,差异有统计学意义(t=11.512、13.809,P<0.05)。治疗后,研究组和对照组患者FACT-L评分[分别是(81.0±8.3)分、(70.2±8.2)分],高于治疗前[分别是(49.5±7.5)分、(49.4±5.9)分],且研究组高于对照组,差异有统计学意义(t=9.163,P<0.05)。结论 肺叶切除术后患者予以雾化吸入布地奈德、特布他林和用乙酰半胱氨酸可将其肺功能改善,减轻炎症反应并改善日常生活的质量。
Objective To explore the efficacy of nebulized triple therapy on patients undergoing lobectomy for lung cancer and its impact on lung function and prognosis.Methods Lung cancer patients selected from 196 cases of thoracoscopic lobectomy treatment in the Sixth People's Hospital of Nantong City from January 2020 to November 2023 were divided into 2 groups according to the difference of postoperative nebulized drμg treatment.The study group consisted of 100 patients treated with nebulized inhalation of budesonide,formoterol,and acetylcysteine,while the control group included 96 patients treated with nebulized inhalation of budesonide combined with formoterol during surgery.The differences in clinical efficacy between 2 groups were compared.Results After treatment,the duration of coμgh relief,reduction of moist rale and postoperative hospitalization in the study group((5.5±1.1)d,(6.5±1.2)d,(8.0±1.5)d,respectively)were shorter than those in the control group((8.7±1.5)d,(7.6±1.4)d,(10.8±2.5)d,respectively).The difference was statistically significant(t=17.080,5.914,9.552,all P<0.05).After treatment,the complication rate of the study group was 2.0%(2/100),and that of the control group was 2.1%((2/96)(χ^(2)=0.002,P=0.967).After treatment,the maximum gas volume(MVV),maximum expiratory flow rate(PEF),ratio of forced expiratory volume to forced vital capacity(FEV1/FVC)in the first second of study group and control group were((85.0±11.1)L,(78.3±9.9)L;(3.8±1.1)L·s^(-1),(2.7±0.7)L·s^(-1);(82.9±10.5)%,75.7±8.8)% were higher than before treatment((62.4±8.0)L,(62.1±8.5)L;(2.0±0.6)L·s^(-1),2.1±0.5)L·s^(-1);(60.7±8.9)%,(60.3±7.7)%),and the study group was higher than the control group.The difference was statistically significant(t=4.327,5.011,4.490,all P<0.05).After treatment,C-reactive protein(CRP)and procalcitonin(PCT)in study group and control group((9.5±1.7)mg·L^(-1),(13.7±1.5)mg·L^(-1);(3.3±0.6)μg·L^(-1),(4.2±1.1)μg·L^(-1),respectively),It was lower than before treatment(18.3±2.5)mg·L^(-1),(18.5±2.7)mg·L^(-1);(5.4±1.0)μg·L^(-1),(5.3±1.2)μg·L^(-1)),respectively),and the study group was lower than the control group,the difference was statistically significant(t=11.512,13.809,both P<0.05).After treatment,the FACT-L scores of study group and control group((81.0±8.3)points and(70.2±8.2)points,respectively)were higher than those before treatment((49.5±7.5)points and(49.4±5.9)points,respectively),and the difference was statistically significant(t=9.163,P<0.05).Conclusion Nebulized inhalation of budesonide,formoterol,and acetylcysteine helps improve lung function in patients undergoing lobectomy for lung cancer,reduces levels of inflammatory factors,alleviates inflammatory reactions,and enhances patient quality of life.These findings are worthy of clinical reference.
作者
钱数银
丁小荣
厉传艺
潘泷璐
黄蓓
Qian Shu-yin;Ding Xiao-rong;Li Chuan-yi;Pan Long-lu;Huang Bei(Department of Thoracic Surgery,Nantong Sixth People's Hospital,Nantong 226000,China;Department of Rehabilitation,Nantong Sixth People's Hospital,Nantong 226000,China;Department of Respiratory Medicine,Nantong Sixth People's Hospital,Nantong 226000,China)
出处
《中国药物应用与监测》
CAS
2024年第4期442-445,共4页
Chinese Journal of Drug Application and Monitoring
